to the members of the general assembly - puc · labor and industry (ovr). the tdd program is funded...

PENNSYLVANIA PUBLIC UTILETY COMMISSION

COMMONWEALTH or PENNSYLVANIA

HARRISBURG, PENNSYLVANIA

WENDELL F. HOLLANDCHAIRMAN September30, 2005

TO THE MEMBERSOF THE GENERAL ASSEMBLYOF THE COMMONWEALTH OF PENNSYLVANIA:

In accordancewith 35 P.S. § 6701.4(e),’thePennsylvaniaPublicUtilityCommission(Commission)respectfullysubmitsits AnnualReporton theTelecommunicationDeviceDistributionProgram(TDD Program)andthePrint MediaAccessSystemProgram(Print MediaProgram,which is alsoknownas“Newsline”). TheTDD ProgramandPrintMediaProgramareoperatedby theOffice of VocationalRehabilitationin theDepartmentofLaborandIndustry(OVR). TheTDD Programis fundedfrom theTelecommunicationRelayServiceProgram(TRS) surchargeandthePrint MediaProgramis fundedfrom specialgrantswith thepossibility ofadditionalfinds from theTRS surcharge.While thePrint MediaProgramis addressedin this AnnualReport,thePrint MediaProgramis still in its infancy.This is the Commission’stenthAnnual ReportaddressingtheTDD Program.

Theattachedreportsummarizesthefollowing aspects:1) TDD ProgramfUnd

balance;2) TDD Programrevenuesreceivedfrom July 2004throughJune2005;3) statementofthe TRS surchargelevel establishedpursuantto § 6701.4(c);4) disbursementsand expensesof thefind; 5) an accountoftheTDD ProgramandPrintMediaProgramexpenses;6) OVR reportedInformation;and7) PublicUtility CommissionConclusion. An electronicversionof this report is availableon theCommission’swebsite(w~w~puc..Saiea.us)underthe“Telecommunications”and“TelecommunicationsRelay”tabs.

Verytruly yours,

WendellF. HollandChairman

Attachments

Section5(e)ofAct 34 of 1995, asamendedby Act 174 of 2004.

ANNUAL REPORTON THEFISCAL STATUS AND OPERATIONSOF THE TELECOMMUNICATIONSDEVICE DISTRIBUTIONPROGRAMAND THE PRINT MEDIA ACCESS

SYSTEMPROGRAM

SUBMITFEDBYTHE PENNSYLVAMA PUBLICUTILITY COMMISSION

OCTOBER1, 2005

In accordancewith 35 P.S.§ 6701.4(e),’thePennsylvaniaPublicUtilityCommission(Commission)respectfullysubmitsits Annual ReportontheTelecommunicationDeviceDistributionProgram(TDD Program)andthePrintMediaAccessSystemProgram(PrintMediaProgram,which is alsoknownas“Newsline”).2 Thesetwo programsareoperatedby theOffice ofVocationalRehabilitation(OVR) in theDepartmentofLaborandIndustry(L&I). TheHiram G. AndrewsCenter(HGAC), in Johnstown,Pennsylvania,is thecurrentTDI) Programmanager. TheCommissionprovidesassistanceto theHGAC in accordancewith thedirectivesoftheUniversalTelecommunicationsandPrint MediaAccessAct, 35 P.S.§~6701.1— 6701.4(e)(2004). TheTDD Programis fundedfrom theTelecommunicationRelayServiceProgram(TRS)surchargeandthePrintMediaProgramis fundedfrom specialgrantswith thepossibility ofadditionalfundsfrom theTRS surcharge.While thePrint MediaProgramis still in its infancy,this is the Commission’stenthAnnual Reporton theTDD Program,which begandistributingequipmentin 1997.

TDD PROGRAMBUDGET

OnMarch 15, 2005, theOVR filed abudgetwith theCommissionfortheTDDProgramfor theensuingyear. TheTDD Programbudgetfor July 1, 2005,throughJune30,2006, assubmittedby theOVR, is $286,207ascomparedto lastyear’sbudgetof$954,081.OVR’s 2005-2006budgetproposalestimatesthat thecostwill be$266,207.10for equipmentand$20,000for consumereducation.In addition,thebudgetcalculationshowsthequantity,unitcost, andtotal cost,by typeoftelecommunicationsdevice. OVR’ sbudgetproposalis attachedasExhibit A.

OVR’s lower annualbudgetfor thecurrentyearresultsin part from theSeptember30, 2004,endingof OVR’scontractwith thePennsylvaniaStatewideIndependentLiving Council (SILC) to administertheTDD Program. OW issueda Requestfor ProposalfortheadministrationoftheTDD Programwith theintent that anewcontractorwould be in placebyOctober1, 2004. A delayin awardingthecontractwascausedby aformal protest,andtheprotestproceedingsare ongoing. Duringthe interim periodfrom October1, 2004,to thepresent,

Section5(e)ofAct 34 of 1995,asamendedby Act 174 of2004.2An electronicversionofthis reportisavailableontheCommission’swebsiteunderthe

“Telecommunications”and“TelecommunicationsRelay” tabs.

thetemporaryadministrationoftheTDD Programis conductedthroughOVR’s HGAC locatedin

Johnstown,PA.

TDD PROGRAMFUND BALANCE

The TDD ProgramFundbalanceat fiscal yearendedJune30, 2005,was

$703,929.64.

TDD PROGRAMREVENUERECEIVED

TheTDD Programsurchargerevenuereceivedwas $694,376.30for theperiodof

July 1, 2004,to June30, 2005.

TDD PROGRAM SURCHARGE LEVEL

35 P.S.§ 6701.4(c)providesthat:

(c) Additional useofsurcharge.--TheTelecommunicationsDeviceDistributionProgramshallbefundedandthePrint Media AccessSystemprogrammaybefundedby the TelecommunicationRelayServiceProgramsurcharge,as calculatedby thecommissionon an annualbasisunderthemethodologyestablishedby thecommissionin orderenteredMay 29, 1990, andJuly 9, 1990,at DocketNumberM-00900239.

The currentTRS surchargecalculationis basedon the Annual AccessLineSummaryReportsubmittedby wireline local exchangecarriers(LECs)operatingin PennsylvaniaasofDecember31, 2004.

The TDD ProgramfUnd balanceof$703,929.64asofJune30, 2005,wasconsideredadequateto coverthe projectedcostsoftheprogramof$286,207.10for theupcomingfiscal year,andto allow for thecashflow reserve.Thus,basedon thetotal numberofaccesslinessubmittedby theLECs, estimatedexpensesandfinancial statusoftheTRS andTDDProgramfund, the Commissionhassettheresidentialandbusinessmonthlyaccessline surchargeat $0.07 (unchangedfrom 2004-2005)peraccessline and$0.10(decreasedfrom 2004-2005)peraccessline, respectively,effectiveJuly 1, 2005. However,theTDD Programportionoftheoverall monthly TRS surchargeremainedthesame:

PerResidentialaccessline $0.01PerBusinessaccessline $0.01

A copyoftheCommission’sMay 27, 2004, Orderat Docket

No. M-00900239F0009,approvingtheTDD Programsurchargerates,is attachedasExhibit B.

2

TDD PROGRAM DISBURSEMENTS & EXPENSES

The following tableshowsthepaidexpenses,which includeTDD programequipment,educationandadministratorfees,from theTDD ProgramFundfor thefiscalyearJuly 1, 2004,throughJune30, 2005.

ProgramEquipmentandEducation $318,174FundAdministratorFees $ 1,684

Total $319,858

PRINT MEDIA PROGRAM

Thereis no reportedactivity requiringfunding from theTRS surchargeregardingthePrint MediaProgramfor July 1, 2004,throughJune30, 2005, andnoneis anticipatedforJuly 1, 2005, throughJune30, 2006. Thus, no budgetwassubmittedfor thePrint MediaProgram. Thereis no fundbalancefor thePrint MediaProgram,nor haveanydisbursementofsurcharge-generatedfundsbeenmade. Nosurchargerevenueshavebeenreceivedfor thePrintMediaProgram. In that thereis no anticipatedneedto establishafund for thePrintMediaProgramat this time, thereis no componentfor thePrintMedia Programin theTRS surchargefor thecurrentfiscal year.

OWl INFORMATION

On August25, 2005,pursuantto 35 P.S. § 6701.4(e)(2),theOVR submittedtotheCommissioninformationon theTDD Program(datedAugust23, 2005). The reportsubmittedto theCommissionby theOW is attachedasExhibit C.

PUBLIC UTILITY COMMISSIONCONCLUSION

The Commission,in conjunctionwith OVR, auditedtheTDD Programfor thefiscal yearendedJune30, 2004. This audit was completedin 2005, Basedupontheworkperformed,no significant irregularitiesin contractingorcustomereducationwereuncoveredforthatperiod. Further, eligibility criteriaofequipmentrecipientshadgenerallybeenproperlyandadequatelyverified.

The Commissionhasbeenresponsiveto theneedsoftheresidentsofPennsylvaniawho dependuponTDD Programequipment,theTDD ProgramAdministrator(HGAC/OVR), theFundAdministrator(WACHOVIA BAI’JK, N.A.), the TRSprovider(AT&T CommunicationsofPennsylvania,Inc.), andto thedirectivesofthelaw.

The Commission,in conjunctionwith thePennsylvaniaRelayServiceAdvisoryBoard(TRSAdvisory Board),launcheda statewidecampaignin March2004to educatePennsylvania’spublic aboutTelecommunicationsRelayService. Thetwo-yearcampaignfeaturesbillboards,print andradioads,a Websiteat www.parelay.net,atoll-free phone

3

number1-800-682-8706,atravelingexhibit, andan educationeffort aimedat school-agedchildren. TheincreasedTRS awarenessmay affecttheTDD Programneeds.

On February6,2003, theCommissionapprovedtherecommendationoftheTRSAdvisoryBoardpermittingUltratec®to conductatrial oftheCapTeITM captionedtelephonevoice-carry-overrelayservice(CTVRS). TheCommissionissuedaSecretarialletter, datedAugust 19, 2005, convertingthetrial to interim CTVRS. The processof selectingaregularCTVRSprovider for Pennsylvanian’shascommenced. TheinterimCTVRSwill continueto beprovidedby Ultratec®, CapTelInc (CTI), andWeitbrechtCommunicationsInc (WCI). With thecommencementoftheinterim CTVRS, theTDD Programwill furnishuserpremiseequipmenttothoseindividualsthatquali~undertheTDD Programguidelines.

The Commissionwill continueto be attentiveto theimplementationoftheTDDProgramandtheCommission’sfundingoversight.

Following is alist ofExhibitsattachedto theAnnualReport:

Exhibit A: TDD ProgramBudgetSubmittedBy theOffice ofVocationalRehabilitation

Exhibit B: Commission’sOrderApprovingNew SurchargeRates

Exhibit C: TDD ProgramInformationSubmittedBy theOffice ofVocational

Rehabilitation

4

EXHIBIT A

TDD PROGRAMBUDGET SUBMITTED BY THEOFFICE OF VOCATIONAL REHABILITATION

OI~ncEOF VOCATIONAL REHABILITATION

1521 NORTH SIXTH STREET

HARRiSBURG,PA 17102

GannonDirector

0:800-442-6351 800-233-3008TTY • www.state.pa.usPA Keyword:“Disability Services”

DEPARTMENT OF

LBOR & INDUSM~ ___

COMMONWEALTH OF PENNSYLVANIA

Mr. James J. McNulty, SecretaryPublic Utility CommissionCommonwealth of PA Keystone Building400 North StreetP. 0. Box 3265Harrisburg, PA 17105-3265

Dear Mr. McNulty:

March i5,,?Q~I C2cX2S

C

C.

C:Re:Actl8l-2002Telecommunication Device Distribution Program (TDDP)Docket No. M-00900239, File 0002 (May 1996-Original)& Consumer Education Program (March 4, 1999)

Enclosed are five copies of the Budget Filing Information Requirements for the 2005-2006Telecommunication Device Distribution Program, which addresses File Items 1 — 20 and thecost of the Consumer Education Program. The Office of Vocational Rehabilitation projects,based on our nine-year experience, that the estimate cost of the equipment and the consumereducation program will be $286,207.10 for July 1, 2005 to June 30, 2006.

If you have any questions regarding this information, please call Mr. Sandy C. Duncan at (717)772-1659 (Voice).

Sincerel

William A.Executive

WAG/SCD/mlo

Attachments

cc: Eric Jeschke, Financial Analyst, Bureau of Fixed Utility Services, PUCThomas Sheets, Audit Manager, Bureau of Audits, PUCRobert D. Robinson, Program Coordinator, Hiram G. Andrews CenterLucy Shumaker, Administrator, Program, Policy & Evaluation Division, OVRMichele Bornman, Supervisor, Field Support & Training Services Section, OVRSandy C. Duncan, Rehabilitation Specialist, Field Support & Training Services Section, OVR

TELECOMMUNICATION DEVICE DISTRIBUTION PROGRAMBudgetFiling InformationRequirement File Items I ~ 3

DocketNumberM-00900230,File 0002

FILE ITEMS

1- 2 BUDGET ESTIMATE — JULY 1. 2005TO JUNE 30. 2006, r.BREAKDOWN OF THE TYPE OF UNITS, THE PRICEOF EACH tYPE OFUNIT, AND THE NUMBER OF EACH TYPE OF UNIT PROJECTEDTO BEDISTRUBUTED IN THE PROSPECTIVEBUDGETYEAR.

EVAS NoJTYPEOF UNIT # OFUNITS

UNITPRICE

TOTALPRICE

5U-1AS4425 — flY Superprint 4424 145 $ 474.05 $ 68,737.255U-2CSPP8L—TTY with LVD Blue-Green LVD 46 j 616.55 28,361.305U-2CSPP8R—TTY with LVD Rose-Red LVD 17 1 616.55 10,481.355U-2CSPP8A—1TY with LVDAmberLVD 3 616.55 1,849.653FS-5A002 — TI? with Braille Display, Braille Lite M20 3 4,032.75 12,098.255U-21 HA4 — In-Line Headset Amplifier, 40dB 19 33.25 631.755U-9BCTPTP —Amplified Large Button Speaker Phone,Crystal+

152

20

161.50 24,548,00

5AP-23CR01 — Hands Free Speaker Phone RC200 556,70 11,134.0~20,662.505AP-21CL40 — Cordless Phone with Amplification, CL-40 145 142.50

5P-O3CT1O — Cordless Headset Phone, CT-b 20 123.50 2,470.005CF-O3BTFS — Telephone Fluency System, Case Futura 3 945.25 2,835.754AT-O1LPSK—Talking Keyboard, Link Plus Kit 10 2,512.75 25,127.5054P-25LBJ5 —Talking Telephone, Amplified JV35 16 133.00 2,128.005E1-1OAB5 — Voice Activated Dialer, Able Phone 5000 17 209.00 3.553.005AP-26APP3 — Photo Phone, Amplified P300 3 47.50 142.50SET-15BBP— Big Button Phone, Braille Phone 17 38.00 646,005U-4BUN1 11 — Voice Carryover IT? 1140 23 265.05 6,096.155AP-OIQ9OS — Hearing Carryover TTY, Q9OD withSpeakers

7 270.75 1,895.25

5AP-29LVCO — Voice Carryover Amplified Phone,VC076570

30 180.50 5,415.00

5U-31CTEL — Captioned Amplified Telephone, CapTel 25 470.25 11,756.255U-9CCTRO — Loud Ring Signaler, Crystal Tone Ringer 195 42.75 8,336.255U-BA2TLT — Flashing Light Signaler, Simplicity LT 244 40.85 9.967,405AA-1 1OVR — Vibrating Signaler, Omni Page Kit 40 F 183.35 7,334.00

Total: $266.207.1O

1, 2. BUDGET ESTIMATE FOR CONSUMEREDUCATION:JULY 1. 2005 - JUNE30! 2006

ConsumerTraining. $20,000.00

Total: $20,000.00

BudgetEstimateof Equipment $26&207A0

BudgetEstimateof ConsumerEducation 20,000.00

Total of BudgetEstimate(2005-2006) $286,207.10

FILE ITEMS:

3. OVERVIEW OF THE

TELECOMMUNICATIONS DEVICE DISTRIBUTION PROGRAM

I. Eligibility:

• Resident of Commonwealth• Certification of a Qualified Disability• Financial Eligibility - Annual Gross Income must be at or

below 200% of poverty level• Phone Service in Home• Age of Person• Able to use telecommunication device

2. Sconeof Program:

Equipmentavailable:

• TTY Superprint 4425• TTY with Large Visual Display, Blue-Green LVD• TTY with Large Visual Display, Rose-Red-LVD• TTY with Large Visual Display, Amber LVD• flY with Braille Display, Braille Lite M20• In-Line Headset Amplifier, 40 dB

Amplified Large Button Speaker Phone, Crystal-f• Hands-Free Speaker Phone, RC200• Cordless Phone with Amplification, CL-40• Cordless Headset Phone, CT-b• Telephone Fluency System, Case Futura• Talking Keyboard, Link Plus Kit• Talking Telephone, Amplified JV35• Voice Activated Dialer, Able Phone 5000• Photo Phone, Amplified P300• Big Button Phone, Braille Phone• Voice Carryover TTY 1140• Hearing Carryover TTY, Q9OD with Speakers• Voice Carryover Amplified Phone, VC076570• Captioned Amplified Telephone, CapTel

• Loud Ring Signaler, Crystal Tone Ringer• Flashing Light Signaler, Simplicity LT• Vibrating Signaler, Omni Page Kit

Ownership/Maintenance:

• Customer owns equipment, which includes a manufacturerdefect warranty and is responsible for maintenance.

Delivery Method:

• Equipment sent directly to customer from

manufacturer/dealer.

EquipmentLimits:

• Based on certification of the individual’s need.

3. Activities Accomplished:

• The Hiram G. Andrews Center (HAGC) assumed theoperation of the Telecommunication Device DistributionProgram on October 1, 2004.

Work SummaryTo Date:

Activity that has occurred to establish a working program

includes the following:

• Develop a working transition from PA Statewide IndependentLiving Council (S!LC).

• Transfer of information and client files to HGAC.• Set up an office site for the program.• Establish a new toll free voice mail line for the program.• Identify the eligibility of the backlog of applications that were

obtained from SILC.• Make notification to all applicants.• Establish a new database for the program for tracking and

report creation.

• Develop the relationship with the vendor, Electronic VisionAccess Solutions (EVAS) to provide the devices.

• Input all eligible applications into the database.• Create a purchase release detail for the database and

prepare items for release.• Issue release orders.• The anticipation is to release future orders on the first

Monday of each month.

TDDP Activity Reportfor the periodof 10/1/04through12131/04:(After Transferto HGAC)

• Total number of applications reviewed 297• Eligible Applications 170• Non-eligible Applicants 38• Non-responsive to requirements applications 46• Applications denied due to equipment selection 25• In-process applications 18

• Total number of releases issued 170• Total number of devices issued for release 282• Total dollar value of devices issued $60,526

• Total number of invoices received and approved b30• Total number of telephone call responded to 469• Number of requested applications mailed 345

BudgetFiling InformationRequirements:File Items4 - 20

DocketNumberM-00900230,File 0002

FILE ITEMS:

4. 2003-2004BudgetandBreakdownof the Actual Numberof Units

Distributed& theActual Costof Units Distributed:

As of July 1, 2003 — June 30, 2004, b ,679 pieces of equipment have

been distributed. (See AttachmentA)

$353,497.10 (See Attachment A)

5. DesignatedAdministrator:

(As of October 1, 2004)Hiram G. Andrews Center727 Goucher StreetJohnstown, PA 15905

814-255-8200 (Voice)814-255-5873 (TTY)866-227-6810 ext. 8728 (Voice)814-255-3406 (FAX)

Contact Person: Robert D. Robinson, Program Coordinator

6. Distributor: Electronic Vision Access Solutions (EVAS),

Westerly, Rhodes Island (See Attachment B)

7. Description: (See Attachment C & D)

A. Residency: Applicant will provide proof of residency by attaching oneof the following to the application: a current driver’s license, non-driver photo I.D., utility receipts, dated Social Securitycorrespondence, local, state, or Federal tax returns with preprintedname and address, etc. (See Attachment C — Application, Page 4).

B. Person with a Disability: A licensed physician, licensed audiologist, alicensed speech pathologist or other recognized state agency (e.g.Office of Vocational Rehabilitation Counselor, Department of Public

Welfare or Social Security Administration Case Worker, Departmentof Aging, Department of Education, Department of Health, Office forthe Deaf and Hard of Hearing) must certify on the application that theapplicant has a disability and is capable of learning how to use thetelecommunication device selected. (See Attachment D - Application,Page 3, Section 7).

C. Telephone Service: Applicant must attach a copy of their phone bill.

D. Six Years of Age or Older: The age of the applicant is part of theapplication.

E. Income: Applicant must indicate his/her gross income and attach

evidence to verify that amount. (See Attachment C, Page 4).

8. Applicant Tracking:

Applicant is tracked by Social Security number.

9. Delivery of Equipment:

The vendor directly ships the equipment to the applicant’s house via

UPS.

10. Ownershipof Equipment:

The applicant owns the equipment. No funds are available toestablish an audit of equipment to determine if it has been traded orsold.

11. Maintenanceof Equipment:

Applicant is responsible for maintaining equipment. Manufacturerswill repair or replace equipment under the Manufacturer DefectWarranty. (See Attachment C, Page 2).

12. Insuranceof Equipment:

Applicant is responsible for insuring the equipment. (See AttachmentC, Page2).

13. Ownershipof Equipment:

Applicant owns the equipment. No tracking system is beingdeveloped, as no funds are available to administer this program.Therefore if the person moves the equipment goes with him/her.

14. More ThanOneEligible Person in a Household:

There are no household restrictions; it is based on an individual’s

qualification.

15. Useof Equipment at Job Site:

The applicant owns the equipment and can use it anywhers he or shewishes. The law did not address this issue.

16. Useful Life of Equipment:

Manufacturers have agreed to provide a manufacturer defectwarranty. If equipment breaks after the expiration of the warranty,the applicant will apply for new equipment. The useful life varies foreach piece of equipment but one would anticipate the equipmentlasting 3-6 years and possibly longer.

17. Replacement Equipment:

The applicant could reapply and be evaluated against the same initialcriteria. The applicant would need to be eligible to receive equipmentinitially or for reapplication.

18. Any Procedural Changesor Updates:

The current poverty level guidelines as of March 2005. (SeeAttachment E).

19. A Copy of Any Audit(s):

No audits have been completed at this time.

20. Any Additional PertinentInformationor Comments:

Work ItemsTo Be Addressed:

• Determine the vendor and cost of training for equipment use.• Establish a warranty period for equipment.• Determine the cost of an extended warranty through

consultation with EVAS.• Develop satisfaction surveys for the TDDP.• Finalize the development of the database for retrieval of data

for monthly, quarterly, annual, and as-needed reports.• Development of the website for the TDDP.

IssueTo Be Resolved:

• The Commonwealth’s decision to allow the HGAC to administerthe TDDP program is temporary, the status of permanentdisposition of the RFP is pending outcome of the continuingappeals by the Pennsylvania Industries for the Blind andHandicapped.

ATTACHMENT A

STATUS REPORTJuly 1,2003—June 30, 2004

APPLICATIONS FORMS:

• The total individual requests for application forms were 1,309. Thetotal requests for application forms from organizations/agencies were1,359. TDDP received 1,925 completed applications from July 1,2003 to June 30, 2004.

EQUIPMENT DISTRIBUTED TO APPLICANTS:

• Equipment was distributed to 726 applicants. Note: Applicants arepermitted to select two (2) companion items, i.e.: TTY and a signalingdevice.

• The following is a breakdown of equipment distributed:

Braille-TTY 4Light Signaler 481Amplified Telephone 145TTY 38Loud Ringer 312Headset Phone 3TTY Pro 80 LVD 67Big Button Phone 9Photo Phone 3VCO Telephone 25VCOTTY 172Cordless Head/Phone 2HCOTTY 1Voice Activated Dial 16Talking Telephone 6Cordless Phone 87Vibrating Signaler 93DV4 2MT4 2DynaWrite 20In-Line Amplifier 191

Total: 1,679

VENDORS:

• Contracts for equipment are with the following vendors:

Compu-TTY, Inc, Fort Worth, TexasHarris Communication, Eden Prairie, MinnesotaHear-More, Inc., Farmingdale, New YorkPotomac Technologies, Rockville, MarylandDynaVox Systems, LLC, Pittsburgh, Pennsylvania

• Total expenditures to each vendor for equipment during the fiscalyear, July 1, 2003 - June 30, 2004:

Harris Communication $ 21,778.30Potomac Technology $107,712.55Health Science $ 16,924.56Compu-TTY $ 22,860.00DynaVox $166,451.00Hear-More $ 17,770.69

Total: $353,497.10

ATTACHMENT B

Founded in 1979 by Gerald and Catherine Swerdlick, Electronic Vision Access Solutions isa family run, privately held corporation, located in Westerly, Rhode Island. EVAS specializesin the design and manufacture of Computer Access Solutionsfor people who are visually, physically, hearing or learningdisabled. Bydevelopingthe unique process ofcombiningAccess ~ ~Technology, application software and computers, EVAS was a Cpioneer in the hi-tech world of Accessible Plug & Play Systems. i~i~EVAS has assisted in the development of speech synthesizers,large print software, CCTVs and other Access Technology and ‘4. L - -~. - .. -.

markets these products throughout the United States.

As one of its primary objectives, EVAS searches out, evaluatesand acquires new and innovative Access Technology, It hascreated close working relationships with dozens of industryleaders worldwide and proudly distributes the Access Solutionsmanufactured by over fifty. independent companies. Thisapproach places EVAS in a strong position to design, integrateand support Accessible Computer Systems that meet the diverseneeds of its Customers.

With twenty-three years of experience as both a user and aprovider of Access Technology Solutions, C.E.O., Jerry Swerdlick,has implemented a mission charterwith theend-user specificallyin mind. Its goal is to assist people with disabilities, by creatingcustomized, easy-to-use Plug & Play Accessible ComputerSystems. EVAS Access TechnologySolutionsare tools that can beused to gain independence - an independence, which can openthe doors to further education or employment opportunities anda better quality of life.

EVAS monitors and controls the manufacturing of its baselinecomputer systems, thus avoiding the incompatibilities that canoccur when off-the-shelfsystems are used. EVAS Dell Xtra SeriesSystems are manufactured using industry leading high-qualitycomponents and are UL-rated, FCC-approved and EPA EnergyStar-compliant.

EVAS Dell Xua Series Computers are fullyfunctioning plug & playsystems that run right out of thebox with all Access Technology, application software and peripherals installed and configured.

EVAS’ senior staff, with over sixty years of experience in microcomputers, programming, AccessTechnology and their inter-relationships, has been drawn from both the academic and corporateworlds. Its qualified staff stands readyto assist in all aspects of the design and support ofAccessTechnology Solutions. EVAS System Engineers are Dell, Microsoftt, HP and A+ certified.

EVAS has a long history of fulfilling the needs of individuals, businesses and state and federalagencies for Accessible Computer Systems. Its staff of experienced consultants can design atotal solution, creating fully integrated accessible computer systems that meet the needs ofpeople who are visually, physically, hearing or learning disabled.

t! It. .: . . . t .

casi!.~~~’ t~.. n’i ~ JQli a~—

EVAS created the e-Source Website to provide easy access to information about the Companyand its products, support and services. The website also offers access to EVAS web basedapplication programs that can be used to evaluate, manage and purchase Access TechnologySolutions. EVAS e-Source interactive web-based application programs are on the cutting edgeof today’s digital information and electronic commerce revolution. The e-Plan and e-Consultprograms, two of the power tools on EVAS website, can be used by State or Federal Agencies,Rehab Engineers or Consultants to plan and purchase computer access solutionsforconsumerswith disabilities. Individuals can use EVAS e-Selectto configure and purchase computer AccessTechnology Solutions, while e-Price can be used to search through all EVAS products andservices, and review their specifications and pricing.

EVAS Dell Xtra Series systems fulfill the requirements of the Americans with Disabilities Actand meet the standards set forth in Sections 504 and 508 of the Rehabilitation Act. EVAShas been designated as an ADA Contractor by the GSA and it’s Plug & Play Solutions are alsorecommended bythe National Federation of the Blind.

Toll Free: 800-(JSA-EVAS : .- C. Email: [email protected] Free: 800-872-3827 . . . .. ... techh&[email protected]: 401-596-3155 . . . .. TTY: 401-596-3500FAX: 401-596-3979 .: . . www.evas.com

ATTACHMENT C

COMMONWEALTH OF PENNSYLVANIATELECOMMUNICATION DEVICE

DISTRIBUTION PROGRAM

TheTeleconimunicationDeviceDistributionProgram(TDDP) establishedbyAct 34-1995 andamendedby Act 18 1-2002providestelecommunicationdevicesto qualifiedapplicants.Thesedevicesenableeligible individualsto accesstelephoneservicesindependently.To be eligible, individualsmustcompletetheenclosedapplicationand.meetall criterialistedbelow.

Personswith a Disability: A personwith a disability or disabilitiesthatpreventshim/herfrom makingorreceivingtelephonecallsindependently.A licensedphysician,audiologist,speechpathologistor a representativeofa qualifiedStateagencymustcertif~tthedisability. (E.g. OVR, Counselor,DPWorSocial SecurityAdministrationCaseWorker)

IncomeLimits: Individual grossincome of200% of Federal Poverty levelor less. (Not including family/household income)

Age: Six (6) yearsor older.

Residence: A residetit ofPennsylvania.

Resources: Must have accessto residential telephoneserviceandpossessthe ability to learnhow to useatelecommunicationsdevice.

Information will bekept confidential, except as required by law. If you needhelp incompletingthis application, or needit in an alternate format, pleasecall.

Return the completedapplicationandrequired documentationto:

HiramG. AndrewsCenterTelecommunicationDeviceDistribution ProgramAttention R.D. Robinson, Program Coordinator

727 Goucher StreetJohnstown, PA 15905

Voice: 866 227-6810(ext. 8728)Or

814-255-8200flY: 814-255-5873Fax: 814-255-3406

1RevisedMarch2005

DISABILITY CATAGORIES

Deaf: A personwith asevereto profoundhearingloss,who is usuallyunableto usethetelephoneeffectivelywithouttheassistanceofaTTY orVoiceCarryoverTTY.

Hardof Hearing: A personwith hearingloss,who is usuallyunableto usethetelephoneeffectivelywithouttheassistanceof soundamplificationequipment.

SpeechImpaired: A personwith aspeech-impairmentwho is usuallyunableto usethetelephoneeffectivelywithouttheassistanceof specializedtelephoneequipment.

Deaf-Blind: A personwith ahearinglosscombinedwith avisualdisability requiringalargevisualdisplayorBrailleoutputTTY to communicateeffectivelyon thetelephone.

Physical: A personwith aphysicaldisability that impedeshis/herability to lift, hold,dial or evenreachthe phone in time to answeran incoming call.

Low Vision/Blind: A personwith low vision or blindnessthat impedeshis/herability todial a standardtekphoneindependently.

Cognitive: A personwho is unableto read,look up, or recall telephonenumbersin orderto dial independentlyon a standard telephone.

Equipment will be delivered to your homevia UPS. It then becomesYOURproperty and YOUR responsibility. NOTE: There i~a Limited ManufacturerDefectWarranty on all equipment purchased under this program. If yourequipmentis defectiveor if it should fail, it will be your responsibility astheconsumerto contact the Manufacture for warranty repair.

WARNING: Repairs for damagesdueto abuseor neglectare not coveredunderanywarranty and are the SOLE RESPONSIBILITY ofthe applicant. Stolenequipment can only be replacedupon receipt of a copy of thepolice report

2

TELECOMMUNICATION DEVICE DISTRIBUTIONPROGRAM

FINANCIAL ELIGIBILITY CRITERIA:ANNUAL GROSSINCOME MUST BE

BELOW 200%OF THE POVERTYLEVEL

2005 POVERTYGUIDELINES WITH EXCEPTION OFALASKA & HAWAII

Sizeof Family Unit Poverty 200% ofGuidelines Poverty Level

1 $9,570 ‘ $19,1402 $12,830 $25,6603 $16,090 $32,1804 $19,350 $38,7005 $22,610 $45,2206 $25,870 $51,7407 $29,130 $58,2608 , $32,390 * $64,780

* For Family Units with more than 8 members,add $3,260

for eachadditional member.

Note: PovertyGuidelinesareupdatedevery March.

3

Application Instructions/ChecklistInstructions for completion of the TDDP Application

Be sure to submit photocopiesof thefollowina documentationwith your completedapplication sinceoriginals cannotbe returned.

Checklist

1. Proofof Applicant’sResidenceinPennsylvania(includin! minors):SubmitONE of thefollowing: copyof currentdriver’s license,non-drivetI.D., utility bill,datedsocialsecuritycorrespondence,copiesofW-2‘s, prescriptionreceipt,schoolID., reportcard,library card,or somethingpre-printedwith applicantsnameandaddress.

2. Proofof Applicant’sIncome: Submita copyof eachitemthat appliesto you:IncomestatementsincludingW-2‘5, 1099sor awardlettersforretirementand/orsocialsecurityincome. If you do not havea copyof your socialsecurityincomestatementyoucan call 1-800-772-1213andrequesta “BenefitsVerificationLetter”.Bankstatement’sandpaystubscannotbe accepted.If APPLICANT hasno incomewriteNONE on line 4.

3. Proofof TelephoneService: Copy ofONE pageofyour mostrecenttelephonebillwith your telephone# appearingon it. If phoneserviceis sharedin aresidentialfacility, a signedstatementon letterheadincluding applicant’snameandphonenumberfrom theAdmissionsDirectoror SocialWorkerwill be accepted.

4. CertificationofDisabffity: Havesection7 completedby licensedPhysician,Audiologist,SpeechPathologist,orRepresentativeofa Qualified StateAgency(e.g.OVR Counselor,DPW or Social SecurityAdministrationCaseWorker,Dept.ofAging, Dept.ofEd., Dept. of Health,ODHH), To avoid delaysmakesuretheentiresectionis completedbeforesubmittingthe application.

5. Applicant’s Statement: Applicant must sign anddatesection8 of theapplicationregardlessofage. If applicantis a minor, aparentor guardianmustalsosign anddatesection8.

6. Euuipment SelectionSection: markONE item from section“9A” andONEitem from section“9W’. To avoid delaysDO NOT leavethesesectionsblank, if you do notneedan item from oneof the columnspleasemakenoneneededin thatsection.

* If you are unsureof what type of equipmentmeetsyour needs,the TDDP Program

encouragesyou to contact the PA Assistive TechnologyLending Library. The LendingLibraryallowsyou to borrowequipmentto helpyou decidewhatwill work foryou. Feelfreeto contacttheTDDPProgramfor a locationnearyou.

4

TTYA teletypewriter .

used to type ~messages overthe telephonenetwork toanother TTY or Relay Service.flY includes an answeringmachine with direct connectto telephone lines.

TTY WITHLARGE VISUALDISPLAY

ATTY witha large visual

display. Individual must havesufficient vision to read display.Display colors are Blue, Amberand Rose Red.

AMPLLFIEDLARGE ~J.n .FflIr~qr~’

fl ~t%,I ‘ ...UJL) ~ ~UI “d

SPEAKER ~ ‘C

PHONEA telephonewith volume and ringer control,flashing light for ringing alert.Able to be used with augmentativedevices to hear or speak. Has out-going voice amplification. Hearing

IN-LINEAMPLIFIER

A devicethatcon nectsthe telephone base and thehandset to amplify the incomingvoice. Telephone is not included.

Note: cannot be used withany phone that dials from

the handset.

LIGHTSIGNALER

A devicewhichattachesto a Jampto providea flashingsignal to indicatethat the telephone is ringing.For persons with sufficientvision to be alerted by aflashing light. The lamp is

TELECOMMUNICA11ON DEVICES

aid compatible. not included.

TELECOMMUMCAT~ONDEV~CES

VOICECARRYOVER

TTYTTY withamplified

handsetattached and

Loud Ring Signaler built in.

HANDS-FREESPEAKERTELEPHONEA phoneactivated by amouth/air switch thatcan connect to augmentativecommunication devices.

Relay Service is required to use

VcoTELEPHONE

this equipment. Hearing

This telephonehas a viewscreen to readthe message

aid compatible.

from the Relay Operator but canbe used as a regular telephone.Hearing aid compatible.

LENDING LIBRARYIf you are unsure of what typeof equipment

meetsyour needs, the Liberty Programencouragesyou to contactthe Lending

Library. The Lending Library allows you toborrow equipmentto help you decide what

will work for you. Feetfree to contacttheLiberty Programfor a locationnearyou.

RING SIGNALER

A device thatadjusts the toneto amplify thevolume of thetelephone ring. Adjustable ringof 95 decibels.

TTY WITHBRAILLEDISPLAYCombinesa TTY witha Braille

output device to allow telephonecommunication with another TTYuser or relay service. Individual

VI BRAT! NGSIGNALER

A vibratingsignalsystemwhich usesa transmitter

and a receiver and vibrates whenthe telephone rings. Transmitter

,:~ ,~

must be able to read Braille. has 100-yard radius.

HEARING

CARRYOVERTTY

TTY withspeakers tokeep hands

free for typing.Relay service is required to make

and receive hearing carry over calls.

CORDLESSPHONE

Cordlesstelephonefor ease of

mobility.Also has incoming voice

amplification and tone control.

CORDLESSHPHONE

Compactremote dialingunit withheadset forpeople withlimitedmobility.

TALKINGTELEPHONE

I:~~t.~ .e~

A telephonewith jumbo-sizedbuttons w/Braille

that verbally repeats the numberback to you as you dial it.

VOICE ACTIVATEDDIALER

A device that plugs inbetween the telephonebase and the jack. Justpick up the handsetand it will ask youwhat name to dial.

PHOTO PHONE

A phone thatwill allow you

to dial a numbersimply by pressing

a picture.

1’

7. f.~’J~j3.7-‘IC c.. --..-}. ~~-t:-

.~.:.,

BIG BUTTONPHONE

A phone with bigblack numbers onbig whke buttonsfor easier dialing.

TELECOMMUMCATION DEV~CES

AT ~ ‘s UPeWWS is an easy-to~use,full-sized ke1

boerd and AugmentativemdMtematlve Corswr,unicallon (Mc) device that speaks as you type.It slows you to sate ke~iphrases so you can nix/one and speak in-stantly LinkPLtJS is appropriate for individuals who have suffered Irons a stroke, or traumaticbra/n k3wy, or have acsyoknd Pc/S or other speech disorders,

up*PltlO5,5.5Th, lees.,,, eMiT, de,,lc1l64K’~4,4cc eta paces ueapws spa,

eta,,’ dcpl.y ppppeda’c6,ecs~p,edipp40,1k ps.,wee.5pr,thd.,,e stepS •tease, ‘cas.e‘pace ce,~SIP. .a.04c5

keybe.est,.

“IcolLtoI.ITslag, h.p/np—I Glee

5r 6aclpec.ccr,

eden Seeps ‘pt/anW,p,Ipe.soclcppSled. .cciId. ,peppg epics. u4t~en.c.,.ahes5ecadIts/Il-I, e.sqdsac.as/a, ep.eesa delceLeg b,e.eyar,’_-e Set.,,Sail-Is balt,-ycha~e0’s/p Upest

eflOIrpoSlaL reeruacsSpepsleeieed otceest

4speecte celpa

Sa,h.ege,bI, 5s6,epsl beeped.,

Ac/e.bld. lep-~-IeptedS estee egeosa

eeoteehnrte,flee.th0

stPeed..d. KITa~aep Oat- ccedenA./aeeebI.e.tPasg..—t.Ieeets let.

end p5,5I.eleI,eeeieaebapeee.—bp IeIl,elnveph.epde,e.e.dcleanse/cPeepaaedeiee pes/epieee—’eeeepheesede ‘peel.

5, a, ee.d,d

c.pbe,rpe—ndaadeed SLicedb,ybe..-d eli. 55 lap.Wee b,ybeeeta l,pwtio—QWtRtT endAIpte.b,Ied~Abbeeps/ede, ,ppeedep,—<re.n,“dspet,eceS’~‘ qskkssved .c epa/c..

deco-wand dep/capepybe,;,,- .ttas.d 0e~Ia llet4,PeeatO.ewscdeesetc c,eepeetcst, Oaeppeet anpeed,a- .cpp lens rite, ta llpehpws

uespwsIM en,hecg.aLea laMps b.Lt,s/e,Acp.a.rad,peerT,leph.eenebE, -

ce,-psegce,eLe,s/5t455 uses,ociee ..ed

Ode/c eetee.,c, CadOetenr .o.aet.edweee.ety

SPEECHUaWt.USeec, DEceest ‘peed.eetaeat.,e_dOpe etlie.pptce4c,.dpeel,,4PepeeeM.neLI child the/c. eli Ieegp..g. ‘pGeeeOGee&l.s,uc iespSieIc teIee-Mpeeltes5pe4~kcn~P,eSpecs-s naacp. .eed Oeaeeec

AIssIilIU~flchh~td~Idbi-.ia8UQ,793a9227~-Www4i.sStWotocft.cdfl--.~

THE CAPTIONED TELEPHONE

The Amplified Telephone that Includes Written,Word..for.Word Captions of Everything the Caller Says

ldealfarpeeplewith soenn degreeefheari,pg

toss, thel CaptionedThfephoese (CapTel)pme-hs like aeey other telephonewith grin

lmporleseat add/tion: 51 dkpptesya eveey word

theratlerseysthroughouttheroppeerpatioet.CapTht users cue, ldsedn to the caller, asset -

can alsoplead the ,a’rdtten captions let the

Cepmlpbote’t br/glee disjs/ay winds/es.

111111Liii

r. a

Wfrn fló~ofj$$from ClIpTol!Anyone wilts sottse degree ofitesringtoss who fosds it difficult tounderstand telephone converastloets

People stslog hearing 51116 orasslilive listening denicesPeopLe iho are leaf or hard ofhearing and voice for dsetuselves

“hove ba/ny able to //eec //se peneis’s poke because / costsedeesteod a tot o

twhet they say... Bet the repulse-are

there for pee to still! did eat aadarsfatsd.”

WclPt.e.eeplloa. a! eeeepthtsg p5,-roller pep,epP.lt Is tIns Cupid p

1eoe 4/splay Icune.

• Calls are’neade In a natural manner —

atmply dtil-ehe telephone numberdirectly for the person you are caffing

• Users enjoy natural eteptsoneconversatlonb, and can check thecaptions for added clarity

• Everyone call sue CapTel phone —

simply ham off the captions teatsireto use it as a traditional telephoneCaptions appear nearly sleooltaneooslywitit else spokest words

• CapTel Includes an amplified thin/setand tone cotterolfor clacity - -

Devi°°

ATTACHMENT D

COMMONWEALTH OF PENNSYLVANIATELECOMMUNICATION DEWCE DISTRIBUTION PROGRAM

APPLICATION

Do you aheadyown telecommunicationequipmentsimilar to whatyou areapplyingfor?

YES NO

If YES,pleasecheckthecorrectanswerbelow:

___ My equipmentis brokenor workssometimes___ My equipmentis borrowed

My equipmentdoesnotmeetmy needs

NOTE: If you haveworking equipmentthatmeetsyourneedsyouwill be ineligible for theprogramat this time.

Your eligibility will be determinedwhen you have submittedacompleted application and documentation requested in theApplicationchecklist(refer to page4 of the attachedbooklet). Toavoid delay, pleasetype or print clearly and make sure allsectionsof the applicationhave beencompleted. If questionsdonotpertainto you, write “N/A” on the line provided.

DO NOT RETURN THE ATTACHED BOOKLETReturnCompletedApplicationPages1-5 with Copiesof

Documentationto: -

Hiram G. AndrewsCenter -

TelecommunicationDeviceDistribution ProgramRD. Robinson,Program Manager

727Goucher StreetJohnstown, PA 15905

Application Pagelof 5

1. Nameof person applying for equipment. Dateof BirthLast First Middle MonthiDay/Year

Street Address

(Note: Equipmentwill not bedeliveredto aP0 Box, youmustprovideyour streetaddress)

City! state/zip ______________________________________County ____________Personassistingapplicantwith this application,if any:

Name______________________________—TelephoneNo. - - -

2. Applicant’s SocialSecurity Number. - -

Completethe following if applicantis underage18:Parent/ Guardian’sName ______________________________Parent/ Guardian’sSocialSecurityNumber - -

3e AreaCodeandTelephoneNumber. (home) - -

- (other) - -

4. Annual Income. (List applicant’s income only. Pleaseincludesocialsecurityand!or pensionincomeif applicable. Do not include family! householdincome. If applicanthasno income,pleasewrite NONE) -

$ __________________________

5. Number of Dependents.(includingyourself).

6. Optional. (this sectionis for reportingpurposesonly)

Race:Caucasian Affican-American Asian Latino

Other___________________________(Specify)

Gender:Male Female

Application Page2 of 5

7. CERTIFICATE DISABILITY— Pleasenote: This sectionmustbecompletedby alicensedphysician,audiologist,speechpathologistactingwithin thescopeofhis/herlicense,orrepresentativeof a qualifiedstateagency,suchasOVR Counselor,DPW orSocialSecurityAdministrationCaseWorker. Makesureall linesarecompletedandappropriateboxesaremarkedbeforesubmittingthis application.

Applicantbeingcertified:______________________________________________Last First Middle

Check the typeof disability being certified:Cognitive Deaf — DeafBlind HardofHearing

_Low Vision/Blind Physical SpeechI certify that I am a licensed:

Audiologist ~Physician _SpeechPathologist

Representativeof a QualifiedStateAgency

NameofProfessional_____________________________________________________Title ______________________________________________________________

NameofAgency __________________________________________

StateLicenseNumber ___________________________________________(If applicable)

Areacode& TelephoneNo. _________________ FaxNo. _________________

SignatureofProfessional_________________________________________________

Date_________________________PLEASENOTE: -

1. A CertifiedEvaluationto determinetheappropriatedevicemaybe requiredforfinal determinationof eligibility. If this is requiredtheProgramStaffwillprovideyouwith theinformationnecessaryto comply.

2. A Trial Periodis recommendedby utilizing thePennsylvania’sAssistiveTechnologyLendingLibraryprogram. TheLendingLibrary allows you tobonowequipmentto helpyou determinewhatdevicewill work bestfor you.To locatetheLendingLibraryAssistiveTechnologyResourceCenterin yourarea,call toll-free 877-PAAT LEND (877-722-8536)voice!TTY.

3. Approximately30 daysafterreceiptofthedevice,youwill receiveafollow-upusagereport. Youwill be requiredto completethe evaluationandreturnit totheProgramCoordinator.


8. Applicant’s Statement.I certify thatall informationprovidedon this applicationis true, completeandcorrect. I understandthatif I purposelyprovidefalseinformationI maybesubjectedto legal action. Programofficials havemypermissionto verify theinformationprovided. I certify that I haveread,understandandacceptallconditionssetforth in this applicationandhavetheability to learnto usetheequipmentchosenbelow. Note: This applicationshouldbesubmittedno later than30 daysafteryou havesignedanddatedit. -

SignatureofApplicant (regardlessof age) - Date

SignatureofParentor Guardianif applicantis Minor Date


9. Equipment Selection: You maychooseonly one (1) devicefrom CategoryA

and one (1) signaler from Category B that bestmeetyour needs.

CategoryA (selectonly one of the following):

#5U-1AS4425 TTY Superprint4425#5U-2CSPP8L TTY with LargeVisualDisplay,Blue-GreenLVII)#5U-2CSPP8R TTY with LargeVisual Display,Rose-Red-LVD#5U-2CSPP8A TTY with LargeVisualDisplay,AmberLVD#3F5-5A002 TTY with BrailleDisplay, Braille Lite M20#5U-21HA4 In-LineHeadsetAmplifer, 40 dB#5U-9BCTPTP Amplified LargeButtonSpeakerPhone,Crystal+#5AP-23CRO1 Hands-FreeSpeakerPhone,RC200#5AP-21CL4O CordlessPhonewith Amplification, CL-40#5P-O3CTIO CordlessHeadsetPhone,CT-lO#SCF-O3BTFS TelephoneFluencySystem,CaseFutura#4AT-01LPSK TalkingKeyboard,LinkPlusKit#5AP-25LBJS TalkingTelephone,Amplified J”/35#5ET-IOAB5 Voice ActivatedDialer,AblePhone5000#5AP-26APP3 PhotoPhone,Amplified P300#5ET-1SBBP Big ButtonPhone,Braille Phone

Thefollowing itemswill requireusewith RelayService -

#5L1-4BUN1I Voice CarryoverTTY 1140#5AP-OIQ9OS HearingCarryoverTTY, Q9ODwith Speakers#5AP-29LVCO Voice CarryoverAmplified Phone,VCO76570#5U-31CTEL CaptionedAmplified Telephone,CapTel

NONE (NoEquipmentis needed)

CategoryB (selectonly one of the following):

#5U-9CCTRO Loud Ring Signaler,CrystalToneRinger#5U-BA2TLT FlashingLight Signaler,Simplicity LT#5AA-11OVR Vibrating Signaler,OmniPageKit

- NONE (No Signalerdeviceis needed)

Pleasecheckyour order carefully.


ATTACHMENT E



BELOW 200% OF TIlE POVERTY LEVEL

2005 POVERTY GUIDELINES WITH EXCEPTION OFALASKA & hAWAII


I $9,570 - $19,1402 $12,830 $25,6603 $16,090 $32,1804 $19,350 $38,7005 $22,610 $45,2206 $25,870 $51,7407 $29,130 $58,2608 $32,390* $64,780

* For Family Units with more than 8 members,add $3,260for eachadditional member.

Note: Poverty Guidelines are updated every March.

EXHIBIT B

COMMISSION’S ORDERAPPROVINGNEW SURCHARGERATES

sAt COMMONWEALTH OF PENNSYLVANIAPENNSYLVANIA PUBLIC UTILITY COMMISSIONP.O. BOX 3265, HARRISBURG, PA 17105-3265

May 19, 2005IULITUIDHU

- M-00900239F0009

TO ALL PARTIES

Recalculation of the PennsylvaniaTelecommunications Relay Service Surcharge

To Whom It May Concern:

This is to advise you that an Order has been adopted by theCommission in Public Meeting on May 19, 2005 in the above entitledproceeding.

An Order has been enclosed for your records.

Very truly yours,

-cC2 /~&:1~3’~z~

_-<;~t7,Y~//~ /

‘Janel ~3. McNul’Secretary

EnclosureLJM

PENNSYLVANIAPUBLIC UTILITY COMMISSION

Harrisburg, PA 17105-3265

Public Meeting held May 19, 2005CommissionersPresent:

Wendell F. Holland, ChairmanRobert K. Bloom, Vice ChairmanKim Pizzingrilli

Recalculationof thePennsylvania M-00900239F0009TelecommunicationsRelayServiceSurcharge -

ORDER

BY THE COMMISSION:

In accordancewith ourMay 29, 1990 Orderat DocketNo! M-00900239,which

establishedTelephoneRelayService(TRS) in Pennsylvania,andAct 34 of 1995,35 p.5.

§~670l.l,ci seq., which codified theprovisionof TRS andestablishedtheTelephone

DeviceDistribution Program (TDDP), we have completedthe recalculation ofthe

PennsylvaniaTRS surcharge as it applies to residenceand businessaccesslines for

July 1, 2005, through June 30, 2006.

As part of their continuing obligations under the surcharge recalculation process,

the local exchangecarriers2 have submitted their wireline accessline counts. The total

number ofaccesslines, adjusted for Centrex lines, is 7,881,264,which includes

5,274,584residenceaccesslines and 2,606,680businessaccesslines. The TRS Provider,

AT&T CommunicationsofPennsylvania,LLC, hassubmittedtheestimatedminutesof

useandchargesfor July 1, 2005, throughJune30, 2006. WachoviaBank, N.A,,3 the

Thestatuloryprovisions were subsequentlyamendedby Act 181 of 2002 andAct 174 of 2004to expandTRScoverageandto createthe Print MediaAccessSystem(PMAS),a readingservicefor personswithcenainvisionandphysicaldisabilities. Thelaw is nowcalledtheUniversalTelecommunicationsandPrint MediaAccessAct.2 Including bothincumbentlocal exchangecarriers(ILEC5) and competitivelocal exchangecarriers-(CLECs).Thistotal is further adjustedundera Centrexequivalencyformula.

Hamilton Bank changedits nameto CoreStatesBank N.A. in 1995,as the resultof a merger;to First UnionNational Bank in 1999; and to wachoviaBank,N.A. in2002.

useandchargesfor July 1, 2005,throughJune30, 2006. WachoviaBank,N.A.,3 the

Fund Administrator, hasprovided a statementof the financial status ofthe Fund,4 as well

as its expectedfeesfor next year. The executivedirector ofthe Office ofVocational

Rehabilitation (OVR) in theDepartment of Labor and Industry has submitted its

2005-2006TDDP budget. Additionally, the surcharge will fund thefinal three months of

the2003-2005TRS consumereducation outreachprogram!

Basedupon thenumber of accesslines, the cost ofthe consumereducation

outreach campaign, the estimated2005-2006expensesofthe TRS and the TDDP,6 and

the financial status ofthe TRS Fund, weshall setthe residential and businessmonthly

accessline surcharge at $0.07(unchangedfrom 2004-2005)and $0.10(decreasedfrom

2004-2005),respectively. Effective July 1, 2005,the monthly surcharge shall be

allocatedas follows7:

2005-2006MonthlySurcharge

&~iden BusinessTRS $0.06 $0.09TDDP $0.01 $0.01

Total Surcharge $0.07 $0.10

All surchargerevenuesshall continueto be remittedto theFundAdministrator.8

HantihonBankchangeditsnameto CoreStatesBankN.A, in 1995, astheresultof amerger;to FirstUnionNationalBankin 1999; andto WachoviaBank, N.A. in 2002.

Separateaccountsaremaintainedfor theportion of thesurchargeallocatedto TRSandtheportion allocatedtoTDDP.

OnJune3,2003,AT&T wasdirectedto submitan ImplementationPlan of its proposalfor consumereducationoutreach.On September29, 2003,the Commissionacceptedthe ImplementationPlan. Wi. Green& Associates,Inc. startedthe outreachcampaignin October,2003. The two-yearcampaign,at acostof$500,000peryear,flirtsthrough September30,2005. At that time, the resultsof the campaignwill be evaluated,anda detenninationwill bemadewhetherto continuewith an outreachcampaign.6 Theestimatedannualexpenseis basedon theestimatedminutesof TRS use,estimatedchargessubmittedbyAT&T, estimatedRelayAdvisoryBoardexpenses,estimatedcompensationtothe FundAdministrator,andtheestimatedbudgetfor the TDDPsubmittedby OvR. No surcharged-fundedexpensesare anticipatedfor PMAS for2005-2006.

TheTRS surchargeappearsasa singleline itemon customers’bills butactuallyhas two components.LECSshall remit surchargerevenuesto WachoviaBatik, N.A., Ann: SueMassey,123 S. Broad St., PA4942

Institutional Trust Services,Philadelphia,PA 19109,payableto the “PA RelayserviceFund.”

2

We shall continue our activeoversight of the operations ofthe PennsylvaniaTRS

and continue to collaborate with OVR and its TDDP administrator to ensuredistribution

ofTDDP equipment to low-incomehouseholdsin accordancewith 35 P.S. §~6791.1,et

seq.

Additionally, it shouldbenotedthat, consistentWith ourMay 29, 2003Orderat

M-00900239F0003,the Commission has completedan audit ofthe TDDP for thefiscal

yearendedJune30,2004. Thescopeoftheaudit concentratedon examiningthe

underlyingcostsassociatedwith TDDP duringthe auditperiod. Also reviewedwasthe

certificationoftheeligibility of individualsapplyingfor TDDP participationand the

distributionofTDDP equipmentanddevicesto TDDP participants.Basedon this audit,

the Commissionis generallysatisfied that ratepayer funds were appropriately usedfor the

TDDP during theaudit period.

While theBureauof Audits hasbeenchargedwith auditingAT&T’s budgeted

costsand actualexpendituresofprovidingIRS, AT&T hasundergonesignificant

corporatechangessincetheCommissiondirectedtheaudit. For example,AT&T has

closedvariouscall centers,exited theconsumertelephonemarket,andpetitionedto

mergewith SBC CommunicationsInc., SeeApplicationof SBCCommunications,Inc.

and AT&T Corporation and its Certified PennsylvaniaSubsidiaries,AT&T

CommunicationsofPennsylvania,LLC, TCG Pittsburgh,Inc. andTCG DelawareValley,

Inc. at Docketnos.A-3 Ill 63F0006,A-3 10213F0008,A-3 I0258F0005.While these

changeshavehad an impact,auditingtheIRS’s underlyingprogrambudgetsand

expendituresis importantandnecessaryto ensurefiscal responsibilityregardingthe

finds ratepayersarerequiredto payfor theseprograms;THEREFORE,

IT IS ORDERED:

3

I. That for theperiodofJuly 1, 2005,throughJune30, 2006,theresidence

surchargeperaccessline permonthshall be $0.07 andthebusinesssurchargeperaccess

line permonthshallbe $0.10,unlesswetakefi.irther actionto revisethesurchargeprior

to June30, 2006.

2. Thatall incumbentlocal exchangecarriersandcompetitivelocal exchange

carriersaredirectedto usetheattachedform to remit themonthlyIRS surcharge

collectionsto WachoviaBank,N.A.

3. Thatall incumbentlocal exchangecarriersandcompetitivelocal exchange

carriersaredirectedto file revisedtariff supplementsto becomeeffectiveJuly 1, 2005,on

at leastoneday’snotice, which reflect theresidenceandbusinesssurchargesin

accordancewith OrderingParagraphNo. I, above.

4. ThattheIRS Provider,AT&T CommunicationsLLC, is directedto work

with theBureauofAudits in conjunctionwith on-goingaudit activities.

5. Thata copyofthis Orderbeserveduponall incumbentlocal exchange

carriersandcompetitivelocal exchangecarriers,AT&T CommunicationsCompanyof

Pennsylvania,LLC, the WachoviaBank,N.A., theOffice of’VocationalRehabilitationin

theDepartmentofLaborandIndustry,theOffice of ConsumerAdvocate,the Office of

Small BusinessAdvocate,and the PennsylvaniaTelephoneAssociation.

6. That a copyof this Orderbepublishedin the PennsylvaniaBulletin.

4

7. Thata copyof this Orderbe postedto the Commission’swebsite.

BY THE COMMISSION

JamesJ.McNultySecretary

(SEAL)

ORDERADOPTED: May 19, 2005

ORDERENTERED: HAY 192005

5

REMITTANCE FORM FORMONTHLY TRSSURCHARGECOLLECTIONS 2005-2006EffectiveJuly1, 2005 through June30, 2006

All local serviceprovidersare requiredto collectand remit theTRS surchargerevenuemonthly,by the2O~ofeachmonth,to theWachoviaBank,N.A., ATTN: SueMassey,123 S. Broad St. — PA 4942,Philadelphia,PA 19109.Pleasemakeyour remittancecheckspayableto the PennsylvaniaRelayServiceFund.,usingthe following formatfor the monthly remittance.PleasedirectanyquestionsregardingtheTRS Surchargeremittanceto Eric Jeschkeat(717)783-3850.

number

~T~i~JwrizedSignature:[Dare:~,

r Pe,t,isylvaniaRçjg~ServiceJ.i~UheMonth Ending:

jj~mberofResidentialaccesslines:

(IRS) X $0.06 per line

N~i~mberof Residentialaccesslines(TDDP) )C $0.01 per line

of Businessaccesslines

.

(IRS) X $0.09per line

NumberofBusinessaccesslines

L~~.~~LTDDP)X $0.01 per line

f~Remittance: —~

Makecheckpayableto: PennsylvaniaRelayServiceFund

~fleport and paymentto: WachoviaBank, N.A.SueMassey

PA-4942Institutional Trust Services

I 123 So.BroadStreetPhiladelphia,PA 19109

(Remittancefor: Companyname(s)Address

Comp~pyContact: Name

EXHIBIT C

TDD PROGRAM INFORMATION SUBMITTED BYTHE OFFICE OF VOCATIONAL REHABILITATION

OFFICE OF VOCATIONAL REHABILITATION

800-442-6351 800-233-3008TTY

Commissioner Wendell F. HollandChairmanPennsylvania Public Utility Commission400 North StreetP0 Box 3265Harrisburg, PA 17105-3266

Re: Annual Report to the General Assembly, Act 181-2002

Dear Commissioner Holland:

Attached is the information requested by the Pennsylvania Public UtilityOffice of Vocational Rehabilitation (OVR) for inclusion in the report to thethe Telecommunication Device Distribution Program.

If you have any further questions, please do not hesitate to contact Bob Robinson at 814-255-8200, ext. 8506 or [email protected].

Sincerely,

William A. GannonExecutive Director

Aftachments:

Cc: Raymond WalkerThomas WashicSandy DuncanKenneth PuckettDon RullmanRobert RobinsonEric7MSJeschke, Analyst, PUC

www.state.pausPA Keyword: “Disability Services”

Commission from theGeneral Assembly on

C.!)

DEPARTMENT OFLB0R & INDUSTÜYCOMMONWEALTH OF PENNSYLVANIA

1521 NORTH SIXTH STREET

HARRISBURG, PA 17102

August 23, 2005

WAG:TEW:djs

ANNUAL REPORT TO THE GENERAL ASSEMBLYACT 181-2002

TELECOMMUNICATION DEVICE DISTRIBUTION U

PROGRAM

IN OVERSEEING THE TELECOMMUNICATION DEVICEDISTRIBUTION PROGRAM (TDDP), THE OFFICE OFVOCATIONAL REHABILITATION (OVR) REPORTS THEFOLLOWING FISCAL YEAR ACTIVITIES BEGINNING JULY 1,2004 to JUNE 30, 2005:

November17, 2002 thePennsylvaniaGeneralAssemblyenactedHouseBill 2424 to amendAct 1995 —34, this expandedthe definition oftheprogramfrom peoplewho are deal; deaf-blind, hardof hearingandspeechimpairedto all disabilitiesthatpreventa personfrom usingstandardtelecommunicationequipment. This expansionof the definitionwill add tothe typesof telecommunicationequipmentthat will be distributedto thequalifyingprogramapplicants. ThisAct wassignedby GovernorMarkSchweikeron December9,2002,and is now knownasAct 181-2002.

TheOVR in theDepartmentof Labor andIndustryis responsibleforthe oversightof theTDDP. TheAct designatedthat the TDDPbe fundedbyan additionalcomponentof the existingTelecommunicationRelayServiceProgramsurcharge,as calculatedby the PA PublicUtility Commissiononan annualbasis. The law specificallydid not allow for administrativecoststo be levied againstthe surchargefunds. As of October1, 2004,the OVRdesignatedthe HiramG. AndrewsCenter(HGAC) to administerthe TDDP.

TheTDDP Advisory Committeewasformedat the directionanddiscretionof the former OVR ExecutiveDirector. Sincethat time, thecontractfor an outsideagencyto performthe administrationof the TDDPhasbeensuspendedin litigation. As a result,the OVR hashadtotemporarilyassignthe administrationof the TDDP to the HGAC, until thelitigation is resolved.Following resolutionof the TDDP litigation, the needfor a TDDP Advisory Committeewill be reassessed.

1

ELIGIBILITY REQUIREMENTS FOR THE TDDP:

• ResidentofPennsylvania

• Qualify asa personwith a disability or disabilitiesthatpreventshimlherfrom makingor receivingtelephonecalls independently.Alicensedphysician,audiologist,speechpathologistor a representativeofa qualified state agencymust certify thedisability (e.g. OVRCounselor,Departmentof Public Welfareor SocialSecurityAdministrationCaseWorker).

• Currentlyhastelephoneserviceandis capableof usingthe requested

device.

• Six yearsold or older.

• Individualgrossincomeof200%of FederalPovertylevel or less(notincluding family/householdincome,currently$19,140peryearfor asingle individual).

OPERATION OF THE PROGRAM:

• During this fiscal the PA StatewideIndependentLiving Councilprovidedfor the day-to-dayoperationsoftheTDDP for theperiodof7/1/04through9/30/04. For theremainingfiscal periodof 10/1/04through6/30/05theHGAC administered the TDDP. For this reason,somestatisticalreportingwill referencebothperiods.

APPLICATION FORMS:

• During theperiod 10/1/04to 6/30/05, HGAC distributed 1,161applicationsto organizations,agenciesandindividual requests.Duringthis sameperiodHGAC receivedand reviewed a total of 576individual applications. Ofthe 576, a total of 393 weredeterminedeligible, 45 determinednon-eligible,75 non-responsivetorequirements,27 denieddueto theequipmentselection,15 on-holdpendingthePUC determinationof the Cap-Teldeviceand21 werecurrently in-process.

2

EQUIPMENT DISTRIBUTED TO APPLICANTS:

• The equipment distribution detail that was extracted from the SILCdatabasefor applicants,duringtheperiodof 7/1/04to 9/30/04isattachedandreferencedas “ATTACHMENT No. 1”.

• The equipmentdistributiondetail by theHGAC for 393 eligibleapplicants,duringtheperiodof 10/1/04to 6/30/05is attachedandreferencedas“ATTACHIIvIENT No. 2”.

• In bothperiodsapplicantswerepermittedto selecttwo (2) companionitems, i.e.: TTY anda signalingdevice.

• The distribution of the CapTeltelephonedeviceis currentlyon holdpendingthecompletionof theprocessesrequiredby thePUCtoobtainaserviceprovider. ThemostrecentPUC announcement,dated5/25/05is attachedandreferencedas “ATTACHI’vIENT No. 3”.

FUNDING:

• Themarketvalueof the TDDP fund as of June30, 2005 was$698,656.59. A month-endmarketvaluereportthatwasprovidedbyWachoviaBank,N.A. is attachedandreferencedas“ATTACHMENT No. 4”.

VENDORS:

• During the periodof 7/1/04to 9/30/04the following equipmentvendorswere usedby the SILC:

o Compu-TTY, Inc, Fort Worth, Texaso Harris Communication,EdenPrairie,Minnesotao Hear-More,Inc., Farmingdale,New Yorko PotomacTechnologies,Rockville, Marylando DynaVoxSystems,LLC, Pittsburgh,Pennsylvania

3

Total funddisbursementsto eachof theabovevendorsduringthisperiodis as follows:

Compu-TTY, Inc. $ 11,410.00HarrisCommunication 9,750.15Hear-More,Inc. -0-PotomacTechnologies 15,512.50DynaVox Systems,LLC. 116,444.00

Total $ 153,116.65

• During theperiodof 10/1/04to 6/30/05HGAC utilized thePADepartmentof GeneralServicescontractvendorfor assistivetechnology(CN00006715/legacy#5850-06) through:

o ElectronicVisionAccessSolutions(EVAS), Westerly,RI

Total funddisbursementsto EVAS duringthis periodwere$143,610.90.

• A disbursementreport, asprovidedby WachoviaBank,N.A., for theperiodof7/1/04through6/30/05is attachedandreferencedas“ATTACHMENT No. 5”.

PUBLIC OUTREACH:

• No activity to report for theperiodof 10/1/04to 6/30/05.

TRAINING:

• No activity to report for the periodof 10/1/04to 6/30/05.

4

ISSUES:

• The PennsylvaniaStatewide Independent Living Council had acontractwith theOVRto administerthe TDDP until September30,2004. In March2004,the OVR issueda Requestfor Proposalsforthe administrationof theTDDP with the intentthat acontractfor thatadministrationwould be in placeby October1, 2004. A contractfortheadministrationwasnot in placeby October1, 2004 becauseof adelaycausedby the filing of a formalprotestto the awardofthecontract. Theproceedingstowardresolutionof thatprotestareongoing. In the interim period betweenOctober 1, 2004 andtheawardof acontractfor theadministrationof theTDDP, theOVRdesignatedthe Hiram G. AndrewsCenterto temporarilyadministertheTDDP.

ATTACHMENTS:

• Referenced• Referenced• Referenced

• Referenced

• Referenced• Attachment

• Attachment

• AttachmentNo. 8• AttachmentNo. 9• AttachmentNo. 10

• AttachmentNo. 11

“EquipmentDistribution by SILC”“EquipmentDistribution by HGAC”“CapTel 5/25/05 Notification letter”“Month-endMarketValues”“WachoviaDisbursementSummary”“HGAC Summary Report”“HGAC County Report”“HGAC AgeReport”“HGAC RaceReport”“March 2005 Application Form”

“PUC Web Site”

No. 1

No. 2No. 3No. 4No. 5

Attachment

Attachment

AttachmentAttachmentAttachment

No. 6No. 7

5

• “Afl*UIlMbtJi’ NO. £//2)/2005 ITEMS ORDEREDTHROUGHLIBERTY TDDP PROGRAMFROM 0710112004-0913012004

Description Coun Unit Price IQ!~1Able-Phone5000 VoiceActivatedDialer 1 $31200 $312.00

AmeriphoneDialogue CL-40 CordlessPhone 2 $135.50 $271.00

AmeriphoneDialogueJV35 Talking Telephone 1 $127.50 $127.50AMERIPHONE DIALOGUE VCO PHONE VCO TELEPHONE 2 $149.18 $298.36

AMER-Q90HCO TTY 21 $324.80 $6,820.80DYNAVOX DV 4 6 $9,776.00 $58,656.00

DYNAVOX DYNAWRITE 5 $5,235.00 $26,175.00DYNAVOX MT 4 3 $9,024.00 $27,072.00

KROWN BRAILLE-TTY BRAILLE-flY I $5,695.00 $5,695.00SouthwesternBell Big ButtonPhone 1 $33.60 $33.60

ULTRATEC CRYSTAL TONEPLUSAMPLIFIED TELEPHONE 28 $83.00 $2,324.00

ULTRATEC SUPERPRINT4425 TTY 5 $370.00 $1,850.00ULTRATEC SUPERPRINTPRO 80 LvD TTY PRO 80 LVD 2 $505.00 $1,010.00

ULT1tATEC UNIPHONE 1140 VCO fly io $225.46 $2,254.60

88 $132,899.86

5JGNALERS

Descrij~ion Coun Unit PriceOmni PageRecievervibrating Signaler 5 $145.95 $729.75UltratecCrystalToneRingerLoud Ringer 24 $23.50 $564.00ULTRATEC SIMPLICITY PHONE LTD LIGHT SIGNALER 28 $23.50 $658.00

57 $1,951.75

Numberof DevicesOrdered 145

Total OrderAmount $134,851.61

Numberof AwardedApplicants 88

“ATThCEENT No. 2”

Eqalpment/Siqnalers ReleasedFrs li/U V2IøJA 1W~U7/15i281$

S

Description Count Unit Price Total

4AT.-01 LSK LinkPlus kit (w/O2LPAC/O3LPkG/O4LPMG) 7 $2,512.55 $17,587.85

SAP-Ui Q9OS HCO vco Q900 TIY w/spk’s 3 $270.75 $812.25

SAP-21cL40 cordless CL4O Amp. Phone 37 $142.50 $5,272.50

5AP-23CR01 Hands-Free RC200 Spk. Phone wlaccessory 12 $556.70 $6,680.40

SAP-25LBJ5 Talking JV35 Amp. Braille Phone 6 $133.00 $798.00

SAP-26APP3 Amplified P300 Photo Phone I $47.50 $47.50

5AP-29LVCO Voice Carryover Telephone- DialogueVCO 9 $180.50 $1,624.50

5ET-1OAB5 Voice Activated Dialer - AblePhone 5000 22 $209.00 $4,598.00

SET-I5BBP Big Button Braille Phone 3 $38.00 $114.00

Sp-O3CTIO Cordless CTIO Headset Phone 3 $123.50 $370.50

5U-1AS4425 Superprint 4425 IT? 63 $474.05 $29,865.15

5U-21HA4 In-line 40dB Headset Arnplifer 8 $33.25 $266.00

5U-2CSPP8L TTY wilarge VisualDisplay BIue-Gr ProSO 27 $616.55 $16,646.85

5U-2CSPP8R U? wllarge VisualDisplay Rose Pro8O 5 $616.55 $3,082.75

SU-31 CTEL Captioned Amplified Telephone, Cap/Tel 2 $470.25 $940.50

SU-4BUNII1 Uniphone 1140 VCO IT? 11 $265.05 $2,915.55

SU-9BCTPTP CrystalTone+ Amp Telephone 68 $161.50 $10,982.00

Amp. Large Button Speaker Phone - Crystal Tone + 32 $161.50 $5,168.00

Big Button Braille Phone - Southwestern Bell 4 $38.00 $152.00

Cordless Headset Phone- Plantronics CT1O 3 $123.50 $370.50

Cordless Phone w/Amp - Ameriphone CL-40 32 $142.50 $4,560.00

Hands-Free Speaker Phone - Ameriphone Dia. RC200 5 $556.70 $2,783.50

Hearing Carryover flY-Dialogue Q900 2 $270.75 $541 .50

In-line Amplifier - Ameriphone HA-40 3 $33.25 $99.75

Thursday, June 30, 2005 Page 1 of 2

~ri ptio n C ount Un it Price Total

Talking keyboard - Link Plus kit 1 $2,512.55 $2,512.55

Talking Telephone - Dialogue JV-35 3 $133.00 $399.00

fly - Ultratec 4425 29 $474.05 $13,747.45

TI? w/Braille Display - Braille Lite M20 w/Lite I $4,032.75 $4,032.75

TI? w/Large Visual Display Amber Pro 80 1 $616.55 $616.55

TI? w/Large Visual Display Blue-Green Pro 80 $616.55 $3,082.75

TTY w/Large Visual Display Rose-Red Pro 80 2 $616.55 $1,233.10

Voice Activated Dialer - AblePhone Model 5000 2 $209.00 $418.00

Voice Carryover Telephone - Dialogue VCO 5 $180.50 $902.50

Voice CarryOver fly - Uniphone 1140 UIl-1 140 $265.05 $1,32s.25

Total l144,549.45

SM-I 1OVR Vib. Omni Page Pkg. 15 $183.35 $2,750.25SU-9CCTRO Loud Ring CrsTone 88 $42.75 $3,762.00

5U-BA2TLT Flashing Light LT 112 $40.85 $4,575.20

Flashing Light - Simplicity LI 42 $40.85 $1,71S.70Loud Ring - Crystal Tone 35 $38.00 $1,330.00

Vibrating - Omni Page 6 $183.35 $1,100.10

Total $15,233.25

Total Equipment/Signalers Released: $159,782.70

Thursday, June 30, 2005 Page 2 of 2

“Afl’M.U*1h~NT No. 3’

COMMONWEALTH OF PENNSYLVANIA REFERTOOURNLE

PENNSYLVANIA PUBLIC UTILITY COMMISSIONP.O. BOX 3265, HARRISBURG, PA 17105-3265 M-00900239

May25, 2005

Re: ~ounCement of Interim Serviceof CaptionedTelephoneServiCe

TOALL PENNSYLVANIA CAPTEL TMALISTS:

The SecretarialLetterofMay 12, 2005, at this docketannouncingtheendof thecaptionedtelephonevoice relayservice(CTVRS)trial in Pennsylvaniais herebymodified. TheCommissionandthetrial serviceprovider1 havereachedanagreementtocoverinterim servicewhile theCommissioncontinuestheprocessto implementongoingcaptionedtelephoneservicein theCommonwealth.Thedecisionto provideinterimservicewas madebasedon newinformationresultingfrom negotiationswith the currentproviderof thetrial service,aswell asinputreceivedfrom thePennsylvaniaRelayServiceAdvisory Board, theCommission’sConsumerAdvisory Council, public officials,andcurrenttrialistsof captionedtelephoneservicein Pennsylvania.

Existingtrialists will not experienceabreakor changein service2andwill havetheoption of upgradingto 2-line service;3trial equipmentin theirpossessionwillcontinueto be on loanfrom Ultratec®. The interim servicewill opento newuserswithinapproximately60 daysor whenthe termsandequipmentfeesfor thenewusersarefinalized. Duringtheperiodof interim service,theCommissionwill continueto workexpeditiouslytowardhavingregular(non-trial) captionedtelephoneservicein placeandaccessiblein the Commonwealth.However,thereis no guaranteethatequipmentpurchasedduring interim servicewill be compatiblewith captionedtelephoneserviceaftera regularserviceprovideris selected.

As partof its responsibilityto protectthepublic interest,theCommissionwillwork to ensurethatcaptionedtelephoneserviceis consistentwith theobligationsinherent

Ultratec® Inc. providedthe trial service,usingCapTeITMtechnology-basedtelephonerelayservice,whichusesavoicerecognitionmechanismin conjunctionwith a call centerandcaptioningtelephonestodisplayconversationsalmostsimultaneouslywith thespokenwords. Theserviceis designedfor usebyindividualswho can speakbutexperiencesomedegreeofhearingloss. CapTelInc. (CTI) operatesthecall center locatedin Madison,Wisconsin. WeitbrechtCommunicationsInc (WCI) is the exclusivedistributorofthe CapTelTM captioningtelephones.Ultratecwill providethe interimservice.2 EffectiveJune1, 2005,currenttrialists will be promptedby their equipmentto download a free upgrade

thatwill provideadditional911 and711 features,speeddialing capabilities,captioningofexternalvoiceansweringmachinemessages,andSpanish-to-Spanishcall setup, if applicable. Thesetswill continuetooperateastheyhaveif oneelectsnot to completetheupgradeprocess.The updateprocesstakesapproximatelyfive minutesduring which time onecannotusetheCapTelset. For moreinformation,checkthe Commission’swebsitei ://www.puc.state.pa.ps/telecgm/telecomreJay service.aspx.

Currenttrialistswho wishto upgradeto theoptional2-line servicewill needto contactboth CapTelcustomerservicefor the 2-line upgradeandtheir local exchangecarriersto arrangefor a secondlocal line.

in theprovisionofpublic utility service. Further,theCommissionwill continuetomonitoradvancementsin technologyto ensure Pennsylvanianswho aredeaf,hardofhearing,andspeechdisabledhaveaccessto thelatesttechnology.

For technicalquestions,pleasecontactCapTelcustomerserviceat 888-269-7477(Voice/CapTel),800-482-2424(flY), or service(~cavtelmail.com.Hoursare8:00AMto 5:00 PM CentralTime. For equipmentpurchases,pleasecontactWeitbrechtCommunicationsat 800-233-9130orwww.weitbrecht.com.

Pleasedirectotherqueriesto Tom Charles,the Commission’sManagerofCommunications,717-787-9504,thcharles(~tate.pa.us.

Sincerely,

Jam(sJ. McNulty(Secretary

cc: ChairmanHollandVice ChairmanBloomCommissionerPizzingrilliRobertRosenthal,BFUSJunePerry, Legislative AffairsThomasCharles,CommunicationsFrankWilmarth, Law BureauCarolTaylor,BusinessMgr., HGACRobertRobinson,ProgramCoordinator,HOACTRSAdvisory BoardConsumerAdvisory CouncilOffice of ConsumerAdvocateOffice of Small BusinessAdvocate

WachoviaPortfolio Online - PrinterFriendly Page1 of 1“ATTACHMENT No. 4”

Month-EndMarketValues

Account: 1525026942- PA RELAY SERVICETDD FUND

Currentdate/time:7/18/20054:53:35PMMonth-End Date Market Value Amount Changed

From Prior Month7/30/2004 218,932.25 0,008/31/2004 241,822.60 22,890.359/30/2004 240,786.71 (1,035.89)

10/29/2004 261,655.94 20,869.2311/30/2004 372,270.48 110,614.5412/31/2004 394,860.76 22,590.281/31/2005 414,536.68 19,675.922/28/2005 469,975.42 55,438.743/31/2005 523,348.47 53,373.054/29/2005 585,285.12 61,936.655/31/2005 656,975.55 71,690.436/30/2005 698,656.59 41,681.047/15/2005 704,274.59 5,618.00

* Accruedincomenot included.

Clf/~Afl afl/flflc t_._1_fl\T ~~n/nflfl_-~\m fl/flflT~ /1fliflfl~C

“ATTACHMENT No. 5”

[70 50)IPAYMENT VAYMEHT POTOMAC TECHNOLOGY INC INVOICE#I0877&I08780 OTO _________ 7/19/2004j1525025942/ 8/11/2004/OIS8UR5EMENT I p PAYMEN1 PAYMENT PO1OMAC TECHNOLOGY INC INVOICE#I08676 108878 0Th — 7/26/04 GROSS $1450 5OiCR MEMO $2350#097463 = $142700l525026942~ 9/79/2004[OISBURSEMENTI (/2~� [PAYMENT — [PAYMENTPOTOMACTECHNOLOGY INC INV#I096031096~iINV J#1095811096851NV #10971510972201O9/14/04&

12L7[~P9~P !M~QPM 2~L~X~T._ 7 ~ INv?A09 fi~Vo109795~l097989/301O4Ir4V - ,~ aq~q!/~P!0 Pft~MPP- ~1ë.294T9 ——- 1~~~ ——-—-t —-—..-. ~—...—..,-~-—-—-,.,.,,.— - I

Account .: Entry (2/ Trans Dose .Anl000t D/shi~ O~042 (7/ 101 (1/St 5/P [MENO PA\IIEFJT/521020942 7/i 5/2001 0/000RSEMENT PAYMENT

/525020042 2/22/11/52 O/500RSE/ACNT .YI1ENTPzs626942i 7130/2004.OISEURSEMENT /02 :PAYMENT

1525025942L8/11/2004[DISBURSEMENT[ /532/rot/PAYMENT15250269421 8/11/2004 DISBURSEMENT

Royce.PAYMENT POTOMAC TECHNOLOGY, (NC~ INCPAYMENT POTOMAC TECHNOLOGY. INC

:PAYMENT POTOMAC TECHNOLOGY. (NCPAYMENT POTOMAC TECHNOLOGY, INC

.ExpIo/n TX I /Epto/nTX2 :Expla/nTX3INVOICE//l05592-105505 DTD :50004 GROSS -3632.50 + 145.55 CR MEMO #097237 = 3455.65INVO/1 E#108o84 0/507/9/04 —

/NVOICE#105745-10/3752 0/50 7/15/04 GROSSS1792.6/3- CR MEMO •094181505.0321287.505NVOICE 95039-41, 98128 98132, 98135:[INVOICEI/108918-106922 DTD F 7/2812004[

ATTACUMENT No.

aHIRAM G. ANDREWS CENTER ___-~____

TelecommunicationDeviceDistribution ProgramActivity SummaryReport

For the Period of 10/1/04through 6/30/05

Eligible Applications 393CapTel Eligible Applications (on hold) 15Total number of Devicesawarded 719Non-eligible Applications 45Non-responsiveto requirements applications 75Applications Denied due to equipment selection 27In-process Applications 21

Total number of Applications Reviewed 576

Total Dollar value of devicesIssued $159,783

Total number of TelephoneCall responds 1,084

Total number of Applications mailed by request 1,161

Other Statistics:

44% of all eligible applicants were over the age of 65

14% of the eligible applicantswere from Philadelphia County and 10% werefrom Allegheny County

Devicetype summary: 37% TTY’s24% Amplified Crystal+SpeakerPhones9% CordlessPhones5% Voice Activated Dialers

www.hgac.org

727 (oucHTR STREET JOHNSTOWN, PA 15905 • 814-255-8200 814-255-5873i-n’ • 814-255-3406FAX

COMMONWEALTH OF PENNSYLVANIA - DEPARTMENTOF LABOR & INDUSTRY - OFFICEOF VOCATIONAL REHABILITATION

AftAU1-i?1!~Nt INO.

CountyReportof Eligible Applicants

From 10/01/2004through 07/05/2005

County CountAllegheny 40

Armstrong 3Beaver 5

Bedford 8Berks 17Blair 17

Bradford 2

Bucks 7Butler 4Cambria 14

CameronCarbon 2Centre 3Chester 11Clearfield I

Columbia 3Crawford 2Cumberland 4

Dauphin 11Delaware 9Elk 4

Erie 14Fayette 8

Forest

Franklin 3Fulton 2Huntingdon 3Indiana 2Jefferson 1Lackawanna 12Lancaster 8Lawrence 7Lebanon 1Lehigh 10Luzerne 9Lycoming 9McKean IMercer 6Mifflin 1

Monroe 3Montgomery 5Montour 2

Thursday.June30,2005 PageI of 2

County Count

Northampton 5Northumberland 2Philadelphia 55Pike 1Potter ISchuylkill 3SnyderSomerset 2SullivanSusquehannaTioga 2UnionVenango 3WarrenWashington 9Westmoreland 20York 10

TOTAL: 393

Thursday,June30, 2005 Page2 of2

‘Afl&UIbthNi NO•

Age Category Report of Eligible Applicants

From 10/01/2004throut!h 07/05/2005

6toI8 28

18to30 25

3OtoSO 90

50to65 75

65 andover 172Totalcount 393

Thursday,June30, 2005 Page1 of I

ALLMAsX1i’LEA~L i’W. ~

RaceCategory Report of Eligible ApplicantsFrom 10/01/2004 through 07/05/2005

Race Count

African-American 56Asian 1Caucasian 283Latino 16Other 6Unknown 31

TOTAL: 393

Thursday,June30, 2005 PageI of I

ATTACHMENT NO.10

COMMONWEALTH OF PENNSYLVANIATELECOMMUNICATION DEVICE

DISTRIBUTION PROGRAM

The TelecommunicationDeviceDistr butionProgram (TDDP) establish&l by Act 34-1995and amended by Act 181-2002 provides telecommunicationdevicesto qualifiedapplicants.Thesedevicesenableeligible individualsto accesstelephoneservicesindependently.To be eligible, individuals mustcompletetheenclosedapplicationand.-meetall criterialisted below.

Personswith a Disabifity: A personwith a disability or disabilities that preventshinalher from making or’feceiving telephone calls -independently.A licensedphysician,audiologist,speechpathologistor arepresentativeof aqualified Stateagencymust certifS’ thedisability. (E.g. OVR, Counselor, DPWorSocialSecurity Administration Case Worker)

IncomeLimits: Individual grossincomeof 200% ofFederal Povertylevelor less. (Not including family/householdincome)

Age: Six (6) yearsor older.

Residence: A residehtofPennsylvania.

Resources: Must haveaccessto residentialtelephoneserviceandpossessthe ability to learnhowto useatelecommunicationsdevice.

Information will be kept confidential, exceptas required by law. If you needhelp incompleting this application, or need it in an alternate format, pleasecall.

Returnthe completedapplicationandreeuireddocumentationto:

Hiram (3. Andrews CenterTelecommunicationDeviceDistributionProgram

Attention RD. Robinson,ProgramCoordinator727 GoucherStreet

Johnstown,PA 15905

Voice: 866 227-6810(ext. 8728)Or

814-255-8200TrY: 814-255-5873Fax: 814-255-3406

IRevisedMarch 2005

DISABILITY CATAGORIES

Deaf: A personwith asevereto profoundhearingloss,who is usuallyunableto usethetelephoneeffectivelywithouttheassistanceofa TTY orVoice Carryoverfly.

Hardof Hearing: A personwith hearing loss, who is usuallyunableto usethetelephoneeffectivelywithouttheassistanceofsoundamplificationequipment.

SpeechImpaired: A personwith aspeech-impairmentwho is usuallyunableto usethetelephoneeffectivelywithout theassistanceofspecializedtelephoneequipment.

Deaf-Blind: A personwith ahearinglosscombinedwith a visual disabilityrequiring a

large visual display or Braille output TTYto communicate effectively on the telephone.

Physical: A personwith aphysicaldisabilitythatimpedeshis/herability to lift, hold,dial or evenreachthephonein lime to answeranincomingcall. -

Low Vision[Blind A personwith low vision orblindness thatimpedeshis/herability todial astandardtelephoneindependently.

Cognitive: A personwho is unableto read,look up, orrecall telephonenumbersin orderto dial independentlyon astandardtelephone.

Equipment will be delivered to your homevia UPS. It then becomesYOURpropertyandYOUR responsibility.NOTE: Therei~aLimited ManufacturerDefect Warranty on all equipmentpurchasedunder this program. If yourequipmentis defectiveor if it should fail, it will be your responsibility as theconsumerto contact theManufacture for warranty repair.

WARNING: Repairsfor damagesdueto abuseor neglectare not coveredunderanywarranty and are the SOLE RESPONSIBILITYof the applicant Stolenequipment can only be replacedupon reèeipt of a copyofthe police report.

- 2



BELOW 200% OF THE POVERTY LEVEL

2005 POVERTY GUIDELINES WITH EXCEPTION OFALASKA & HAWMI


I $9,570 - $19,1402 $12,830 $25,6603 $16,090 $32,1804 $19,350 $38,700S $22,610 $45,2206 $25,870 $51,7407 $29,130 $58,2608 - $32,390* $64,780

* For Family Units with more than 8 members,add $3,260for eachadditional member.

Note: Poverty Guidelines are updated every March.

3

Application Instructions/ChecklistInstructions for completion of the TDDP Application

Be sure to submit photocopiesof thefollowing documentationwith yoUr completed

application sinceoriginals cannot be returned.

Checklist

1. Proofof Applicant’sResidencein Pennsylvania(including minors):SubmitONE ofthe following: copyofcurrentdriver’s license,non-drivef T.D., utility bill,

- datedsocial securitycorrespondence,copiesofW-2’s,prescriptionreceipt,schoolI.D., reportcard,librarycard,or somethingpre-printedwith applicantsnameandaddress.

2. Proofof Applicant’s Income: Submita copyofeachitem thatappliesto you:IncomestatementsincludingW-2’s, 1099sor awardlettersfor retirementand/orsocialsecurityincome. If you do nothavea copyof yoursocialsecurityincomestatementyou cancall 1-800-772-1213andrequesta ‘PenefitsVerification Letter”.Bank statement~andpaystubscannotbe accepted.If APPLICANThasno income~qiteNONE on line 4.

3. Proof of TelephoneService: C.opyof ONEpageofyour mostrecenttelephonebillwith your telephone# appearingon it. if phone serviceis sharedin a residentialfacility, asignedstatementon letterheadincluding applicant’snameandphonenumberfrom theAdmissionsDirector or SocialWorker will be accepted.

4. Certification of Disability: Have section7 completedby licensedPhysician,Audiologist, SpeechPathologist, or Representativeofa Qualified StateAgency(e.g.OVRCounselor, DPW or Social Security Administration CaseWorker, Dept. ofAging, Dept.ofEd.,Dept.ofHealth,ODHH). To avoid delaysmakesuretheentiresectionis completedbeforesubmittingtheapplication.

5. Applicant’sStatement:Applicantmustsignanddatesection8 oftheapplicationregardlessofage. if applicantis a minor,a parentorguardianmustalsosign anddatesection8.

6. EquipmentSelectionSection: markONE item from section“9A” andONE-itemfrom section“9B”. To avoiddelaysDO NOT leavethesesectionsblank,if you do notneedanitem from oneofthecolumnspleasemakenoneneededin thatsection.

* if you are unsureof what type of equipmentmeetsyour needs,the TDDP Program

encouragesyou to contact the PA Assistive TechnologyLendingLibrary. The LendingLibrary allowsyou to borrowequipmentto helpyou decidewhatwill work for you. Feelfreeto contacttheTDDPProgramfor a locationnearyou.

4

TTYA teletypewriter -~ - : ~

used to type- ~A1~t~ ~messagesover

the telephonenetwork toanother TTY or Relay Service.TTY includes an answeringmachine with direct connectto telephone lines.

TTY WITHLARGE VISUALDISPLAYATTY witha large visual

display. Individual must havesufficient vision to read display.Display colors are Blue, Amberand Rose Red.

AMPlIFIED -

LARGEBUTTON

- ‘r --~~flIZ

SPEAKER -. -

PHONE 7——

A telephonewith volumeand ringercontrol, -

flashing light for ringing alert.Able to be used with augmentativedevices to hear or speak. Has out-going voice amplification. Hearing

IN-LINEAMPLI F! ER

A devicethat

connectsthe telephone base and thehandset to amplify the incomingvoice. Telephone is not included.

Note: cannot be used withany phone that dials fromthe handset

LIGHTSIGNALER

A devicewhichattachesto a lampto providea flashingsignal to indicatethat the telephone is ringing.For persons with sufficientvision to be alerted by aflashing light. The lamp is

TELECOMMUMCAT~ON DEVICES

aid compatible. not included.

TELECOMMUMCAT~ON DEVICES

VOICECARRYOVER

TTYTTY withamplified

handsetattached and

Loud Ring Signaler built in.Relay Service is required to use

this equipment. Hearingaid compatible.

VCOTELEPHONE

This telephonehas a viewscreen to readthe message -

from the Relay Operator but canbe used as a regular telephone.Hearing aid compatible.

HANDS-FREE

SPEAKERTELEPHONE

A phoneactivated by amouth/air switch thatcan connect to augmentativecommunication devices.

LENDING LIBRARYif you areunsureof whattypeof equipment

meetsyour needs, the Liberty Programencouragesyou to contactthe Lending

Library. The Lending Libraryallows you toborrowequipmentto helpyou decide what

will work for you. Feel freeto contacttheLiberty Programfor a locationnearyou.

RING SIGNALER

A device thatadjusts the toneto amplify thevolume of thetelephone ring. Adjustable ringof 95 decibels;

t c’

- - -- - ,~-. -

:...~ç~f/

arc! a receiver andthc~teiqhoie iings.

VIBRAT!NGSIGNALER

A vibratingsignalsystemwhich usesa transmitter

vibrates whenTransmitter

TTY WITHBRAILLEDISPLAY

Combinesa TTY witha Braille

output device to allow telephonecommunication with another TTYuser or relay service. Individualmust be able to read Braille. has 100-yard radius.

TELECOMMUMCATION DEVICES IHEARING

CARRYOVERTTY

TTY withspeakers tokeep hands

free for typing.

TALKINGTELEPHONEA telephone

with jumbo-sizedbuttons w/Braille

that verbally repeats the numberback to you as you dial it.

Relay serviEe is required to makeand receive hearing carry over calls.

CORDLESSPHONE

Cordlesstelephone

for ease ofmobility.

Also has incoming voiceamplification and tone control.

CORDLESSHEADSET

PHONE

Compactremote dialingunit withheadset forpeople withlimitedmobility.

VOICE ACTIVATEDDIALERA device that plugs inbetween the telephonebase and the jack. Justpick up the handsetand it will ask youwhat name to dial.

PHOTO PHONE

A phone thatwill allow you

to dial a numbersimply by pressing

a picture.

- / ~:-

BIG BUTTON

PHONE

A phone with bigblack numbers onbig white buttonsfor easier dialing.

I-----

-7

AT ~ ½iJr,kPLUSis an eany-touse,LeO-sizedkeybosrdandAugrnnntativeandftjtemalive Con-visunication(MC) device thatspeaksasyou type.it allows youto save coy phrasessoyoucan retrieveand speakIi-rbzsffy UnkPWSis appropriateforindWidualswho basesufferedIronsastn*e,orb-vssmatic

brain njur~sorhaveacquiredAU orotherspeechdisorders,

M*PWSbe,.1 the~n, .0ATr, do.4.tNIC

tdod., ~‘odcooedtk,&rLtJshn

here. St~eey..MdawU.., Oh. odin1k*~issword.prad.6oncod•dtØiWOOd, asadogopeooa.MeTh,on.ois

HtOt4llCMTeIsa. 6çI.r—5U-totbY O0-dandor

odvg.droodopus

sect. ..coth .c.eo*. op6

—~’—oton,nfl.k~_

- 5.50-ho td0*o.,a-ocoth ont.oeeo doterLoornb.c., nth—o hoe..soot-hootto., thtger

OttoSipan.

AflOtTlotlAt. PeAThR~SSvnOheb.dO�Ct40°~.fl.do 010004

R.d.rp.td. boleooo.Ib.ttod..

4*00.04. ae.—hytnt ft.’ aeU.c.

or tOtdabep0, ,4.t test’s-i.od

dOdartoe moteAo5obtot t.ttop-o.nbe.o.no,oral pathPitt01or.toftsktptoon_byt.o..s

rhotosatotlonooiop5.n,—.trpOs.oJep.WOg,.,no0*d%es.od—tcoOoootM-do.Okssbas-do.ithtOkoao-

- 1w,test’s-U hottta—QOWRTr.nd$.ib.acdSOchyk.yttoynp.,t,ndkayd

• Abbnoifl.o oop.o.oTon-_cn.t.tho.t000d?orflhwea3.r,ptb.o

~9000iOOonooecdJOO.o

tOn~totr.Ini0

,..n Mcok*tUIeervdodanm ,onpod..- to t.n.t oO

pU.00 aptloot tle.-Oo uusws

~.E1 THE CAPTIONED TELEPHONE - ——

The Amplified Telephone that Includes Written,Word-for-Word Captions of Everything the Caller Says

CD_tohtealforpeopleweeksomedegreeofhearing

toss,the CaptionedTelephone(GapSeQworkslikeanyothertelephonewith oneioapnrlsneaddition:It dh$071s conyword

theroller saysthroughoutthe conversation.

CapTeluserscanlisten to thecalIe, and -

-- nit, alro roadthewritten captionsin-theCap7~elpbppesbright displaywindow.

ets

-lAo e.no,oeo.to, It-Il b.toeot,,

L54.PWSu,.,. Gold. —Qtjc011&htenc.C.rtOai-yetnsodsedw.nanby

St~t~CH -

LWPLUS ,50m OECOttIo~oth s50.uttoMbs oOtttoonK.ok.. 4onto.4 toe,!..,od.

otod O,.lc,.rie Ioac..p epeeoeus5.41k uS(butt 0.tho-Mt,*eiSp.othliCuOIt. troth frocot. s-UGs,ow.

W0101toeeafloe..t toeqibsesAt-otior coo..pp.nrho oh, CapT1ph..,,d~piaphues.

- Assletlole tecttnatog4y,1610.- leDOQ.793.9227-.www.dsaIstIveteohl.cont-.

Vthi lionel I$s fràiet- (UpTel ?-. Anyonewllh Santedegreeof tearing

loss,who.finds It difticult tounderstandtelephoneconrersalloosPeopleusinghearingsideor

assumelistessIst~destcesPeople‘also are deaforhard ofhearing-andvoice for themselves

“I love beingohio toboor thepersonspokebecomeIconunderstando lot a!whet theysoy.., Rut theroptions.arothere(or weto reel!! didnot understand.”

Calls are’madeIn a naturalmanner— -

simply 0101-thetelephonenumWrdirectly for he personyou are calling -Usersenjoynatural telephonecnsneasatsnsihassd can checkthecaptIonsfor addedclarity -Everyonecan useCapTed phone—simplytorn off thecaptionsfeatureto use-ilasa traditionaleelephoneCaptionsappearnearly sianultnneosssly

wIth IIae spékenwords

•Cqp Telincludesanamplified handsetand tonecontrol(or clarity -

ATTACHMENT D

COMMONWEALTH OF PENNSYLVANIATELECOMMUNICATION DEVICE DISTRIBUTION PROGRAM

- - APPLICATION

Do you abeadyown telecommunicationequipmentsimilar to whatyou areapplyingfor?

YES NO

If YES, pleasecheckthecorrectanswerbelow:

___ My equipmentis brokenor workssometimes___ My equipmentis bonowed

My equipmentdoesnotmeetmy needs

NOTE: If you haveworkingequipmentthatmeetsyour needsyouwill be ineligible for theprogramat this time.

Your eligibility will be determinedwhen you have submittedacompleted application and documentation requested in theApplication checklist (refer to page4 of the attachedbooklet). Toavoid delay, please type or print clearly and make sure allsectionsof the applicationhave beencompleted. If questionsdonot pertain to you, write “N/A” on the line provided.

DO NOT RETURN THE ATTACHED BOOKLETReturnCompletedApplicationPages1-5 with Copiesof

Documentationto: -

Hiram G. Andrews Center -

Telecommunication DeviceDistribution ProgramR.D. Robinson,Program Manager

727 Goucher StreetJohnstown,PA 15905 -

ApplicationPagelof S

1. Nameofpersonapplyingfor equipment. Dateof BirthLast First Middie Month/Day/Year

Street Address

(Note: Equipmentwill not be delivered to a PCBox, you mustprovideyourstreetaddress)

Cityf state/zip ___________________________________County___________

Personassistingapplicantwith this application, if any:

Name______________________________TelephoneNo. - -

2. Applicant’sSocialSecurityNumber. - -

Completethefollowing if applicantis underage18:ParentI Guardian’sName ________________________________ParentI Guardian’sSocialSecurityNumber - -

3. Area Code and TelephoneNumber. (home) - - -

- (other) - -

4. Annual Income. (List applicant’sincomeonly. Pleaseincludesocialsecurityand /orpensionincomeif applicable. Do not includefamily I householdincome, If applicanthas no income,pleasewrite NONE) - -

$ ___________________________

S. Number ofDependents.(includingyourself).

6. Optional. (this sectionis for reportingpurposesonly)

Race:Caucasian African-American Asian Latino

Other___________________________(Specify)

Gender:Male Female


7. CERTIFICATEDISABILITY Pleasenote: This sectionmustbe completedby alicensedphysician,audiologist,speechpathologistactingwithin thescopeofhis/herlicense,or representativeof a qualifiedstateagency,suchasOVIR. Counselor,DPW orSocial Security Administration CaseWorker. Makesureall lines are completed andappropriateboxesaremarkedbeforesubmitting this application.

Applicant beingcertified:_________________________________________Last First Middle

Check the type of disability being certified:Cognitive ,Deaf — DeafBlind ,Hard ofHearingLow Vision/Blind Physical _Speech

I certify that I am a licensed:

Audiologist Physician SpeechPathologist

Representativeof a QualifiedStateAgency

NameofProfessional__________________________________________________Title ______________________________________________________________

NameofAgency _______________________________________________

StateLicenseNumber ______________________________________________

(If applicable)Area code & TelephoneNo. _________________ FaxNo. _________________

SignatureofProfessional____________________________________________Date_________________________

PLEASENOTE: -1. A CertifiedEvaluationto determinetheappropriatedevicemaybe requiredfor

final determinationofeligibility. If this is requiredtheProgramStaffwillprovideyouwith the informationnecessaryto comply.

2. A Trial Periodis recommendedby utilizing the Pennsylvania’sAssistiveTechnologyLendingLibraryprogram. TheLendingLibrary allows you toborrow equipmentto helpyou detenninewhatdevicewill workbestfor you.To locatetheLendingLibraryAssistiveTechnologyResourceCenterin yourarea,call toll-free 877-PAAT LEND (877-722-8536)voice/TTY.

3. Approximately30 daysafterreceiptofthe device,youwill receiveafollow-upusagereport. You will berequiredto completethe evaluationand return it totheProgramCoordinator.


8. Applicant’sStatementI certify thatall infonnationprovidedon this applicationis true,completeandcorrect. I understand that if I purposely provide falseinformationI maybesubjectedto legalaction. Programofficials havemy permissionto verify theinformationprovided. I certify that I haveread,understandand accept allconditionssetforth in this applicationandhavetheability to learnto usetheYequipmentchosenbelow. Note: This applicationshouldbesubmittedno later than30 daysafteryouhavesigned anddatedit. -

SignatureofApplicant (regardlessofage) - Date

SignatureofParentorGuardian if applicantis Minor Date


9. Equipment Selection: You may chooseonly one (1) devicefrom CategoryAand one (1) signaler from CategoryB thatbestmeetyourneeds.

CategoryA (selectonly oneof thefollowing):

_____ #5U-1AS4425 TTY Superprint4425_____ #5U-2CSPP8L TTY with LargeVisual Display, Blue-GreenLVD

-- #513-2CSPP8R flY with LargeVisual Display,Rose-Red-LVD____ #51J-2CSPP8A TTY with LargeVisual Display,AmberLVI)_____ #3FS-5A002 TTYwith Braille Display,Braille Lite M20_____ #5U-21HA4 In-LineHeadsetAmplifer, 40dB____ #5U-9BCTPTP Amplified LargeButton SpeakerPhone,Crystal+_____ #5AP-23CRO1 Hands-FreeSpeakerPhone,RC200_____ #SAP-21CL4O CordlessPhonewith Amplification, CL-40_____ #SP-O3CT1O CordlessHeadsetPhone,CT-lO_____ #5CF-O3BTFS TelephoneFlueflcy System,CaseFutura____ #4AT-O1LPSK TailcingKeyboard, LinkPlusKit_____ #5AP-25LBJS Talking Telephone, Amplified JV3S_____ #5ET-1OAB5 Voice ActivatedDialer,AblePhone5000_____ #5AP-26APP3 PhotoPhone,Amplified P300

#5ET-ISBBP Big ButtonPhone,Braille Phone

The following itemswill requireusewith RelayService - -

_____ #5U-4BIJN11 Voice CarryoverTTY 1140_____ #5AP-O1Q9OS HearingCarryoverTTY,Q9OD with Speakers_____ #SAP-29LVCO Voice CarryoverAmplified Phone,VC076570

#5U-31CTEL CaptionedAmplified Telephone,CapTel

NONE (No Equipmentis needed)

CategonB (selectonly one of the following):

_____ #SU-9CCTRO Loud Ring Signaler,CrystalToneRinger_____ #5U-BA2TLT FlashingLight Signaler,Simplicity LT

#SAA-11 OVR Vibrating Signaler,OmniPageKit

NONE (No Signalerdeviceis needed)

Pleasecheckyour order carefully.


TelecommunicationsDeviceDistributionProgram Page1 of I“ATTACHMENT No. 11”

I- ~ Home I Site Map Cont~

Utility_N~!~~°P -~ Telecommunication Device Distribution Program -

1TDDP

On July 6, 1995 , GovernorRidge signed Act 34 of 1994, 35 P,S.~67O1.1,etseq., (Act 34) into law establishing the Telecommunication Device DistributionProgram (TDDP). On December 9, 2002 , GovernorMark Schweiker signed Act181 of 2002, which amended Act 34 by expanding the definition of disability(ies) to include any disability that prevents a person from using standardtelecommunication equipment.

The TDDP provides specialized telecommunications devices, such as texttelephones and amplifiers, at no charge to qualifying persons who are deaf orhard of hearing, or with speech and language disorders, or with a physicaldisability that prevents them from using standard telecommunicationequipment, who have gross incomes of less than 200% of the federal povertylevel. Other qualifications that must be met in order to participate in the TDDPinclude: Pennsylvania residency, qualified disability, must be at least 6 yearsold, and must have phone service and the ability to learn how to use thetelecommunications device. The Pa. Department of Labor and Industry, Officeof Vocational Rehabilitation administers the program. The legislation providesthat the equipment distributed under the program will be funded through theTRS Fund.

‘%wS-%, ~ \~Sr4~ ‘~ ~ -~ ----~

-~ Telephone Companies

Rates & Tariffs-- LEC Information

-InterconnectionAgreements

Utility ChoiceArea Codes

Do Not Call ListPA Universal Service

Fund- 911 Service

TelecommunicationsRelay Service

Issues

- Related Links

Us�~n~\ Thi mnqpgation~ \ T ~ \ ~ jç~~gpsp~yic~Pistributio Prc’gr~m

For more information on the TDDP, you may visit the Office of VocationalRehabilitation at the Department of Labor & Industry’s website atwww.dli.state.pa.us. For an application, or to speak with the TDDP processor,you may call Program Manager Robert Robinson at: 814-255-8200 (VoiceOnly) or toll free 1-866-227-6810 (Voice Only); or email atroberrobin©state,pa.us, TTY Users please use Relay Service by dialing 711 toaccess the voice numbers in order to get in touch with Mr. Robinson.

The mailing address is:

Hiram 6. Andrews Center727 Goucher StreetJohnstown, PA 15905

Announcements F Meet Commissioners j Staff Pire&tgry FPress Releases F HleC~p~p~jntsPub~cMeefing~CalendarI 113 &Hc11iioQ~F QlloQEprm~FFjLcSus~R~p~pst~

Regulatory Information

©2005 Pennsylvania Public utilityCommission

FObtain/File Information FFcpo~rm~rfth~ceuIqaF

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