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

RSA-7-OB for Arkansas Division of Services for the Blind - H177B110004 report through September 30, 2011

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year318,203
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year248,438
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2157,397
A2. Total other federal0
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)38,613
A4. Third party0
A5. In-kind0
A6. Total Matching Funds38,613
A7. Total All Funds Expended196,010
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs58,503
C. Total expenditures and encumbrances for direct program services137,507

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 0.5000 2.5000 3.0000
2. FTE Contractors 0.0000 1.0000 1.0000
3. Total FTE 0.5000 3.5000 4.0000

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 0 1.0000
2. Employees with Blindness Age 55 and Older 0 0.0000
3. Employees who are Racial/Ethnic Minorities 1 1.0000
4. Employees who are Women 0 2.0000
5. Employees Age 55 and Older 0 2.0000

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 FY404
2. Number of individuals who began receiving services in the reported FY178
3. Total individuals served during the reported fiscal year (A1 + A2) 582

B. Age

1. 55-5948
2. 60-6455
3. 65-6950
4. 70-7465
5. 75-7974
6. 80-84117
7. 85-8994
8. 90-9459
9. 95-9916
10. 100 & over4
11. Total (must agree with A3)582

C. Gender

1. Female401
2. Male181
3. Total (must agree with A3)582

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race0
2. American Indian or Alaska Native3
3. Asian1
4. Black or African American124
5. Native Hawaiian or Other Pacific Islander0
6. White450
7. Two or more races4
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)582

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)34
2. Legally Blind (excluding totally blind)370
3. Severe Visual Impairment178
4. Total (must agree with A3)582

F. Major Cause of Visual Impairment

1. Macular Degeneration296
2. Diabetic Retinopathy73
3. Glaucoma80
4. Cataracts25
5. Other108
6. Total (must agree with A3)582

G. Other Age-Related Impairments

1. Hearing Impairment145
2. Diabetes164
3. Cardiovascular Disease and Strokes235
4. Cancer62
5. Bone, Muscle, Skin, Joint, and Movement Disorders249
6. Alzheimer's Disease/Cognitive Impairment114
7. Depression/Mood Disorder2
8. Other Major Geriatric Concerns138

H. Type of Residence

1. Private residence (house or apartment)506
2. Senior Living/Retirement Community50
3. Assisted Living Facility16
4. Nursing Home/Long-term Care facility10
5. Homeless0
6. Total (must agree with A3)582

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)105
2. Physician/medical provider18
3. State VR agency52
4. Government or Social Service Agency62
5. Veterans Administration8
6. Senior Center28
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization2
10. Independent Living center0
11. Family member or friend166
12. Self-referral121
13. Other20
14. Total (must agree with A3)582

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 0
1b. Total Cost from other funds 2,140
2. Vision screening / vision examination / low vision evaluation 3
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 9

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 29,860
2. Provision of assistive technology devices and aids 131
3. Provision of assistive technology services 131

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 4,299
2. Orientation and Mobility training 52
3. Communication skills 71
4. Daily living skills 81
5. Supportive services (reader services, transportation, personal 11
6. Advocacy training and support networks 2
7. Counseling (peer, individual and group) 100
8. Information, referral and community integration 52
. Other IL services 119

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 0
2. Information and Referral 0
3. Community Awareness: Events/Activities 19 0

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) 813,023 196,010 -617,013
2. Number of Individuals Served 756 582 -174
3. Number of Minority Individuals Served 143 137 -6
4. Number of Community Awareness Activities 124 19 -105
5. Number of Collaborating agencies and organizations 11 11 0
6. Number of Sub-grantees 0 1

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 131 100.00%
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) 117 89.31%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 0 0.00%
B1. Number of individuals who received orientation and mobility (O & M) services 52 100.00%
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) 52 100.00%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 0 0.00%
C1. Number of individuals who received communication skills training 71 100.00%
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) 0 0.00%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 0 0.00%
D1. Number of individuals who received daily living skills training 81 100.00%
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) 0 0.00%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 0 0.00%
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) 92 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) 0 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) 3 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.

Arkansas is a rural state characterized by a small population, primarily spread out over a large geographic area, with a few pockets in which there is a concentration of older blind individuals. Historically, the Older Individuals who are Blind (OIB) program in Arkansas has delivered services using an itinerate model. Rehabilitation Teachers, with caseload carrying responsibilities, are housed in ten locations throughout the state and co-locate in DHS county offices. This has been the case since the inception of the program in Arkansas and the model has persisted until May of 2011.

At that time, the Division of Services for the Blind entered into its first contractual agreement with World Services for the Blind (WSB) to provide Older Blind Services on a statewide basis. The first WSB contract period continued from May 1, 2011 to September 30, 2011. Under the contract, World Services provided intake, assessment, rehabilitation teaching, orientation/Mobility instruction, low vision services, technology services and follow-up services. The contract was renewed in December 2011.

The Division of Services for the Blind continues to seek referrals from and provide services to individuals in un-served or underserved populations. This includes identifying those referral sources more likely to have initial contact with minority groups, including faith based organizations, Centers for Independent Living, local contacts and community outreach organizations. In addition, DSB is continuing the process of replacing some of the current, and inactive, Older Blind Program Advisory Committee members with a larger number of representatives from our minority communities. DSB will continue this effort as these groups change and grow.

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.

As stated above, rehabilitation teachers actively participate in a wide range of public awareness activities, including the provision of In-Service presentations to a variety of professionals and non professionals. Over the last year, In-Service presentations have been conducted for medical and long term care facilities, schools and universities, groups of blind consumers and consumer organizations, aging programs and to staff in other DHS offices. Rehabilitation teachers also present professional workshops within professional, community and civic organizations. This has been accomplished by either maintaining membership in these entities, providing instruction to staff, manning informational booths and exhibits, and/or offering relevant instruction and information. Additionally, some of the rehabilitation teachers are very active within local support groups for the blind and/or disabled. Each month, these activities are reflected on each rehabilitation teacher’s monthly report. Rehabilitation teachers are strongly encouraged to work collaboratively with Centers for Independent Living, workforce Centers, and any other locally available resources to provide comprehensive services to consumers. In an effort to expand collaborative efforts the following organizations meet on a quarterly basis with the OIB Project: Mainstream, World Services for the Blind, Area on Aging, Library for the Blind, Delta Resources, American Council for Blind, National Federation for the Blind, Division of Aging and Adult Services, University of Arkansas at Little Rock (UALR), AR Information Reading Services and two representatives from the Public Sector. The staff of the Division of Services for the Blind, (DSB), members of the DSB Board, members of the OIB Advisory Committee and consumers participates in blindness awareness promotional efforts throughout the state. DSB staff are involved at all levels in their local communities and may serve on task forces and committees including local workforce boards, local transition planning teams, deaf-blind task force, technology access work groups and program advisory committees. In addition, staff participates in blindness specific support and consumer groups, Association of Persons in Supported Employment (APSE), Association for Education and Rehabilitation for the Blind and Visually Impaired (AER), local Lion Clubs and disability awareness activities. More recently, DSB has initiated a Consumer of the Year recognition program and a Faith Based Bridge contract with the Centers for Independent Living. While these focus on VR services and consumers primarily, the additional awareness and publicity carry over to all programs. Finally, the new OIB service contract with World Services for the Blind (WSB) continues to provide a more cost effective service delivery alternative and provide access to an array of services for consumers.

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.

Consumer Satisfaction Surveys (CSS) are conducted by staff who report directly to the agency director. The collection process for the CSS has changed since FFY 2010. Instead of annually, the surveys are mailed at the end of the quarter to all closed cases. This means that results for the 2010 year are based on responses from closed OIB cases on record for FFY 2011.

RESPONSES TO QUESTIONS

Question Number 1: Services were provided in a timely manner.

Response: Of the 51 surveys received, 2 did not indicate a choice. Of the remaining 49 responses, 23 or .469% strongly agreed, 18 or .367% agreed, 3 or .061% disagreed, and 0 strongly disagreed. This is an overall satisfaction rating of 83.6% for this question, compared to 92.0% for the previous year.

Question Number 2: My telephone calls were returned promptly.

Response: Of the 51 surveys received, 4 did not indicate a choice. Of the remaining 47 responses, 23 or .489% strongly agreed, 16 or .340% agreed, 3 or .063% disagreed, and 0 strongly disagreed. This is an overall satisfaction rating of 82.9% for this question, compared to 92.7.0% for the previous year.

Question Number 3: I was treated with courtesy and respect from all staff.

Response: Of the 51 surveys received, 2 did not indicate a choice. Of the remaining 49 responses, 34 or .693% strongly agreed, 10 or .204% agreed, 0 disagreed, and 0 strongly disagreed. This is an overall satisfaction rating of 89.7% for this question, compared to 97.5% for the previous year.

Question Number 4: I feel my teacher provided me with relevant information and services for my specific situation.

Response: Of the 51 surveys received, 9 did not indicate a choice. Of the remaining 42 responses, 23 or .547% strongly agreed, 14 or .333% agreed, 1 or .023% disagreed, and 0 strongly disagreed. This is an overall satisfaction rating of 89.7% for this question, compared to 97.5% for the previous year.

Question Number 5: My teacher was attentive, concerned, and interested in my well-being.

Response: Of the 51 surveys received, 9 did not indicate a choice. Of the remaining 42 responses, 24 or .571% strongly agreed, 12 or .285% agreed, 1 or .023% disagreed, and 0 strongly disagreed. This is an overall satisfaction rating of 85.6% for this question, compared to 95.6% for the previous year.

Question Number 6: I am satisfied with the amount of contact I had with my teacher.

Response: Of the 51 surveys received, 8 did not indicate a choice. Of the remaining 43 responses, 24 or .558% strongly agreed, 9 or .209% agreed, 5 or .116% disagreed, and 1 or .023% strongly disagreed. This is an overall satisfaction rating of 76.7% for this question, compared to 92.0% for the previous year.

Question Number 7: My teacher was familiar with technology and techniques used by blind and visually impaired people.

Response: Of the 51 surveys received, 10 did not indicate a choice. Of the remaining 41 responses, 22 or .536% strongly agreed, 14 or .341% agreed, 0 disagreed, and 0 strongly disagreed. This is an overall satisfaction rating of 87.7% for this question, compared to 96.2% for the previous year.

Question Number 8: Overall, I am satisfied with how the services helped me achieve my goals for independent living.

Response: Of the 51 surveys received, 5 did not indicate a choice. Of the remaining 46 responses, 23 or .500% strongly agreed, 14 or .304% agreed, 1 or .021% agreed and disagreed, 1 or .021% disagreed, and 1 or .021% strongly disagreed. This is an overall satisfaction rating of 80.4% for this question, compared to 94.8.0% for the previous year.

Question Number 9: I feel that my present vision-related needs have been met.

Response: Of the 51 surveys received, 4 did not indicate a choice. Of the remaining 47 responses, 19 or .404% strongly agreed, 17 or .361% agreed, 1 or .002% agreed and disagreed, 4 or .085% disagreed, and 1 or .002% strongly disagreed. This is an overall satisfaction rating of 76.5% for this question, compared to 88.5% for the previous year.

Comments ranged from, “I greatly appreciated the help I have received - thank you so much - my teacher is a kind, exceptional person”. “The vision aids I received (without any cost to me) have really aided my daily living. This is a wonderful service. “I don’t see how someone in the field can come to your home talk with you and find out what you need, and tell you that she or the company can get it for you, and never call or return back with item in question”.

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).

Mary Sloan- Little Rock

Mrs. Y is a long term patient of a local Retinal Specialist. She has advanced macular degeneration. In her right eye, she has peripheral count fingers only. Her left eye presents with 20/100 vision. Because of her limited vision, she has difficulty with reading, using her slide collection, cooking, and decorating her home. She lives with her husband, who is also disabled.

Due to services from DSB, Mrs. Y is now able to use lighted magnifiers for reading and other tasks. In addition, she uses binocular glasses for television and other distances tasks. High contrast fluorescent keyboard stickers were placed on her keyboard. She is now able to use the computer as a result of this adaptive equipment. Mrs. Y was glare sensitive and was issued filters to be worn over her current spectacle correction. She has medium filters for outdoors and light filters for indoors. Another service provided to Mrs. Y was special marking of her washer, dryer and stove. These services allow Mrs. Y to function more independently in the home. MES CVRT

Jacob Grace -Harrison

Mr. M was diagnosed with aphakia, phthsis, and glaucoma. In his left eye he has no light perception and 20/100+1 in his right eye. Due to his long-term vision loss, he had problems with medication and physical health monitoring, reading, and meal preparation. He was also hospitalized for congestive heart failure near the beginning of his assistance with our agency and is on full-time oxygen. We provided a talking scale, hand-held magnifiers, large-print paper and pens, talking thermometers, and other standard low vision household necessities. Using these items, Mr. M can now function in his apartment independently. He can monitor weight and temperature as needed. He can also read mail and cooking instructions that have help with better meal choices, as recommended due to the heart failure. He also was directed to, and uses, a TAP phone system for communication. Services have helped Mr. M maintain independence at his apartment with minimal outside assistance.

Jimmy Jones-Fort Smith

Mr. Jones has had many successful consumers on the Older Individuals who are Blind caseload, who’ve taken advantage of the opportunities to learn the techniques he’s been able to teach, and have greatly increased their independence and their self-reliance. I believe Ms. Y of Ozark, AR is one such consumer. When Mr. Jones met her, she was in need of several independent living techniques and aids and appliances to help her take care of herself. She was provided with these aids and appliances, a magnifier, tactile markings and clues, and the instruction needed to be able to use all the items provided. When Mr. Jones last worked with her, she was much better able to manage her day-to-day activities and take care of her personal business.

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

The Older Individuals who are Blind (OIB) program in Arkansas is significantly underfunded. Due to the absence of public transportation in such a rural state, itinerant services are necessary, but funding is inadequate to allow the size workforce necessary to provide in-depth and frequent services to the growing population of individuals who are older blind. DSB is fortunate to have a network of very caring organizations that step up to assist consumers and extend the impact of DSB services.

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 byKaty Morris
TitleDirector
Telephone501-682-0360
Date signed12/30/2011