Annual Report - Independent Living Services For Older Individuals Who Are Blind

RSA-7-OB for Alaska Dept of Labor and Workforce Development - Division of Vocational Rehab - H177B110002 report through September 30, 2011

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year225,000
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2225,000
A2. Total other federal3,050
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act3,050
(e) Other0
A3. State (excluding in-kind)25,000
A4. Third party348
A5. In-kind21,994
A6. Total Matching Funds47,342
A7. Total All Funds Expended275,392
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs57,321
C. Total expenditures and encumbrances for direct program services218,071

Part II: Staffing

FTE (full time equivalent) is based upon a 40-hour workweek or 2080 hours per year.

A. Full-time Equivalent (FTE)

Program Staff a) Administrative and Support b) Direct Service c) Total
1. FTE State Agency 0.1000 0.0000 0.1000
2. FTE Contractors 0.3840 4.0100 4.3940
3. Total FTE 0.4840 4.0100 4.4940

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 17 1.9340
2. Employees with Blindness Age 55 and Older 2 0.1240
3. Employees who are Racial/Ethnic Minorities 6 0.1960
4. Employees who are Women 24 4.2020
5. Employees Age 55 and Older 13 0.7900

C. Volunteers

1.00

Part III: Data on Individuals Served

Provide data in each of the categories below related to the number of individuals for whom one or more services were provided during the reported fiscal year.

A. Individuals Served

1. Number of individuals who began receiving services in the previous FY and continued to receive services in the reported FY166
2. Number of individuals who began receiving services in the reported FY164
3. Total individuals served during the reported fiscal year (A1 + A2) 330

B. Age

1. 55-5948
2. 60-6431
3. 65-6940
4. 70-7431
5. 75-7944
6. 80-8441
7. 85-8949
8. 90-9434
9. 95-999
10. 100 & over3
11. Total (must agree with A3)330

C. Gender

1. Female207
2. Male123
3. Total (must agree with A3)330

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race6
2. American Indian or Alaska Native77
3. Asian6
4. Black or African American13
5. Native Hawaiian or Other Pacific Islander2
6. White220
7. Two or more races6
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)330

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)25
2. Legally Blind (excluding totally blind)81
3. Severe Visual Impairment224
4. Total (must agree with A3)330

F. Major Cause of Visual Impairment

1. Macular Degeneration144
2. Diabetic Retinopathy32
3. Glaucoma20
4. Cataracts33
5. Other101
6. Total (must agree with A3)330

G. Other Age-Related Impairments

1. Hearing Impairment87
2. Diabetes64
3. Cardiovascular Disease and Strokes64
4. Cancer43
5. Bone, Muscle, Skin, Joint, and Movement Disorders93
6. Alzheimer's Disease/Cognitive Impairment38
7. Depression/Mood Disorder26
8. Other Major Geriatric Concerns91

H. Type of Residence

1. Private residence (house or apartment)277
2. Senior Living/Retirement Community20
3. Assisted Living Facility17
4. Nursing Home/Long-term Care facility9
5. Homeless7
6. Total (must agree with A3)330

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)72
2. Physician/medical provider14
3. State VR agency18
4. Government or Social Service Agency27
5. Veterans Administration2
6. Senior Center8
7. Assisted Living Facility1
8. Nursing Home/Long-term Care facility7
9. Faith-based organization0
10. Independent Living center24
11. Family member or friend69
12. Self-referral65
13. Other23
14. Total (must agree with A3)330

Part IV: Types of Services Provided and Resources Allocated

Provide data related to the number of older individuals who are blind receiving each type of service and resources committed to each type of service.

A. Clinical/functional vision assessments and services

Cost Persons Served
1a. Total Cost from VII-2 funds 23,653
1b. Total Cost from other funds 601
2. Vision screening / vision examination / low vision evaluation 160
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 0

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 41,306
1b. Total Cost from other funds 2,602
2. Provision of assistive technology devices and aids 256
3. Provision of assistive technology services 262

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 112,167
1b. Total Cost from other funds 10,542
2. Orientation and Mobility training 37
3. Communication skills 201
4. Daily living skills 214
5. Supportive services (reader services, transportation, personal 86
6. Advocacy training and support networks 70
7. Counseling (peer, individual and group) 136
8. Information, referral and community integration 136
. Other IL services 100

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 37,309
1b. Total Cost from other funds 8,306
2. Information and Referral 75
3. Community Awareness: Events/Activities 136 3,138

Part V: Comparison of Prior Year Activities to Current Reported Year

A. Activity

a) Prior Year b) Reported FY c) Change ( + / - )
1. Program Cost (all sources) 280,561 273,762 -6,799
2. Number of Individuals Served 338 330 -8
3. Number of Minority Individuals Served 104 107 3
4. Number of Community Awareness Activities 106 161 55
5. Number of Collaborating agencies and organizations 78 79 1
6. Number of Sub-grantees 4 4

Part VI: Program Outcomes/Performance Measures

Provide the following data for each of the performance measures below. This will assist RSA in reporting results and outcomes related to the program.

Number of persons Percent of persons
A1. Number of individuals receiving AT (assistive technology) services and training 262 100.00%
A2. Number of individuals receiving AT (assistive technology) services and training who maintained or improved functional abilities that were previously lost or diminished as a result of vision loss. (closed/inactive cases only) 138 52.67%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 43 16.41%
B1. Number of individuals who received orientation and mobility (O & M) services 37 100.00%
B2. Of those receiving orientation and mobility (O & M) services, the number of individuals who experienced functional gains or maintained their ability to travel safely and independently in their residence and/or community environment as a result of services. (closed/inactive cases only) 14 37.84%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 9 24.32%
C1. Number of individuals who received communication skills training 201 100.00%
C2. Of those receiving communication skills training, the number of individuals who gained or maintained their functional abilities as a result of services they received. (Closed/inactive cases only) 73 36.32%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 64 31.84%
D1. Number of individuals who received daily living skills training 214 100.00%
D2. Number of individuals that experienced functional gains or successfully restored or maintained their functional ability to engage in their customary daily life activities as a result of services or training in personal management and daily living skills. (closed/inactive cases only) 90 42.06%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 47 21.96%
E1. Number of individuals served who reported feeling that they are in greater control and are more confident in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 85 n/a
E2. Number of individuals served who reported feeling that they have less control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 0 n/a
E3. Number of individuals served who reported no change in their feelings of control and confidence in their ability to maintain their current living situation as a result of services they received. (closed/inactive cases only) 4 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 0 n/a
E5. Number of individuals served who died before achieving functional gain or experiencing changes in lifestyle as a result of services they received. (closed/inactive cases only) 2 n/a

Part VII: Narrative

A. Briefly describe the agency's method of implementation for the Title VII-Chapter 2 program (i.e. in-house, through sub-grantees/contractors, or a combination) incorporating outreach efforts to reach underserved and/or unserved populations. Please list all sub-grantees/contractors.

The Alaska Division of Vocational Rehabilitation administers Independent Living Services for Older Individuals who are Blind through four contracts to non-profit agencies. Since we have such a large state, contracting the funds to agencies located throughout the state allows us to serve individuals who reside in both urban and rural communities. Services are provided in a variety of venues including senior centers, at consumer’s homes, out in communities and in-house at the agencies. Many recreational activities have been conducted outside, some in kayaks and on local trails. Three of the four contractors are independent living centers that provide the full array of IL services that benefit many of our OB consumers. The four contractors are:

1. Alaska Center for the Blind and Visually Impaired, Anchorage 2. Access Alaska Independent Living Center, Fairbanks 3. Independent Living Center, Homer 4. Southeast Alaska Independent Living, (SAIL), Juneau

To identify seniors in need of services and to provide services throughout Alaska, all contractors collaborate and work closely with Senior Centers, Optometrists, Native Health Associations, Senior Housing Programs, Veterans’ Administration, Vocational Rehabilitation and other service providers.

Through networking with partners contractors aim to increase exposure in rural communities as well as link individuals who are unserved or underserved to independent living services. Each year contractors, often in collaboration with senior and healthcare providers, travel to rural and remote areas and conduct outreach. One contractor facilitated the purchase of 4 webcams. These webcams make it possible for older individuals who reside in rural areas to communicate their needs and request assistance. A senior center in Valdez, the Alzheimer’s Resource Center in Glennallen and the Family Resource Center in Cordova (all rural communities), are the recipients of the webcams. Video contact with elders and their providers is maintained on a regular basis.

Public Service Announcements regarding IL Older Blind services were routinely aired throughout the state, brochures have been developed and distributed and electronic newsletters have assisted greatly in our public awareness and outreach efforts.

B. Briefly describe any activities designed to expand or improve services including collaborative activities or community awareness; and efforts to incorporate new methods and approaches developed by the program into the State Plan for Independent Living (SPIL) under Section 704.

Partnerships with agencies that serve visually impaired clients have actively been sought and developed with senior centers, Tribal Vocational Rehabilitation programs, eye doctors and numerous service providers throughout the state. In Alaska, collaboration and partnerships make it possible to identify and better serve elderly individuals with visual impairments. The relationship with Lions Clubs continues to be strong, to the benefit of older visually impaired Alaskans. The Independent Living Centers across the state exchange ongoing support, and the new Alaska Vision Alliance (the Center, the Alaska Optometric Association, and the Alaska Primary Care Association is addressing gaps in eye care health statewide. ATLA, the lead assistive technology provider in the state, remains a significant reciprocal resource along with the Division of Vocational Rehabilitation and the Tribal Vocational Rehabilitation programs.

The success and growth of the Older Blind Program is in part due to the popularity of the program and word of mouth. An increasing number of people with vision impairments and service providers, including eye doctors are aware of services. In many communities monthly service provider meetings are attended to increase public awareness, brochures are distributed to all eye doctors and PSA’s are aired quarterly. Quarterly check-ins are conducted with all participating consumers. Numerous health fairs are attended by contractor staff who man booths providing low vision assistive technology and information about the program. Due to agency collaboration many people have received recommendations for and trained on the use of various assistive technology including talking books and magnifiers. One contractor conducts an annual fundraising and awareness event entitled “Seeing With Our Hearts”. This year’s event generated an audience of over 250 individuals.

To promote community awareness of the Older Blind Program, one contractor started a Visually Impaired Support Group at the Fairbanks Pioneer Home. Monthly meetings were held for the residents who are visually impaired and blind. The average age of participants was 87 with four residents over the age of 90. Peer support, independent skills training, low vision and communication accessibility were some of the services provided during the meetings.

C. Briefly summarize results from any of the most recent evaluations or satisfaction surveys conducted for your program and attach a copy of applicable reports.

All contractors routinely solicit feedback and assess the satisfaction of their older blind and visually impaired consumers. They have discovered the best way to obtain feedback is by quarterly check-ins with consumers through personal visits or phone calls. This approach takes more time, but allows for more detailed, personal responses.

This past fiscal year consumers were contacted every quarter. They reported feeling satisfied with the services they received from the Older Blind program. One woman said, “This program helped so much with support and assistance in getting low vision aids. It also helped me with paperwork and just giving me support”. A man stated, “The magnifier that the agency loaned me has greatly improved my small carving work, and I can now fix my own toes”. Another woman said, “Their expertise and knowledge of what was available far exceeded mine. Assistance in finding and obtaining sight magnification equipment was very helpful”.

Feedback about the Older Blind program has been excellent. Our surveys and reports directly from consumers verify that the Older Blind program provides peer support, valuable resources and excellent opportunities for individuals to try out assistive technology.

D. Briefly describe the impact of the Title VII-Chapter 2 program, citing examples from individual cases (without identifying information) in which services contributed significantly to increasing independence and quality of life for the individual(s).

1. One contractor has been working with an elder, who is 95 years old and diagnosed with cataracts and glaucoma, both of which have severely impacted his ability to read. He has been an avid reader all of his life. He recently lost his wife of over 60 years and has become very isolated. He said he really wanted to be able to read books and newspapers again. After visiting several times with him in his home, the contractor found a magnifier/light combination that allows him to read again. She also set him up with a digital recorder from the talking books library and he now listens to his favorite books. This contractor was also able to find a volunteer that on a weekly basis assists him to search the library loan list for his favorite books.

2. A call was received from an elder, who has macular degeneration that allows only peripheral vision. She lives 28 miles from town in a home that she and her husband have owned for over 40 years. Her husband died several years ago. She has a very large screen computer set up in her home with several programs installed for her that she does not know how to use. The contractor was able to find a volunteer with high level of computer skills to work with her twice a week to teach her how to use the computer programs. During home visits several issues were discussed. Realizing she is living alone with a severe vision impairment, the contractor asked if she would like some information about the Medic Alert (Lifeline), that she could use while in the house in case of a fall or other emergency. She was relieved to know there was something like that available. The contractor assisted her in contacting a local company which installed the system.

3. Through an agreement with a contractor, a consumer was able to purchase a hand held video magnifier (Ruby). The Ruby enabled him to continue his love of woodworking by allowing him to magnify his project plans. He was also able to take the magnifier into the community and use it while shopping to read labels and other activities where magnification was needed. He enjoys the portability of the Ruby and described it as “taking handheld magnification to the next level and beyond”.

E. Finally, note any problematic areas or concerns related to implementing the Title VII-Chapter 2 program in your state.

The cost of health care and the lack of insurance is a concern to many older blind and visually impaired consumers. Contractors report that one of the biggest obstacles to people with low vision is the lack of funding needed to obtain eye treatment, glasses and other assistive technology they need. Although impaired vision is a common issue for our aging population, many consumers have expressed concern that Medicare does not cover typical vision services or low vision aides and devices. Although partnerships with the Lions Organization have been of assistance for purchasing low vision examinations and eyeglasses, there still remains a high number of seniors who can’t afford the vision services and assistive technologies they need to live safely and independently.

Traveling to provide services in remote communities and villages can very quickly become expensive and occasionally impossible, but we do our best to serve as many people as possible in our large state within budget constraints. The majority of the state is predominantly rural, where many communities are not connected by a road system. This makes travel expensive and sometimes difficult, particularly in the winter when the weather is less agreeable to travel in small planes or boats. As a result, many consumers who reside in these communities receive sporadic services.

Many of the contractors have reported that the 7OB report does not correspond with the MiCIL program, (a database used for tracking data needed for the IL 704 report) making it difficult and time consuming to track similar data that is needed for both annual reports. An upgrade to the MiCIL program was made in 2011, but many problematic issues still exist

Part VIII: Signature

As the authorized signatory, I will sign, date and retain in the state agency's files a copy of this 7-OB Report and the separate Certification of Lobbying form ED-80-0013 (available in MS Word and PDF formats.

Signed byVelja Elstad
TitleIL OIB Program Coordinator
Telephone907 465-6932
Date signed12/22/2011