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

RSA-7-OB for Indiana Bureau of Rehabilitation Services - H177B110014 report through September 30, 2011

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year661,626
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year809,948
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2550,801
A2. Total other federal805,432
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement0
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other805,432
A3. State (excluding in-kind)0
A4. Third party340,865
A5. In-kind0
A6. Total Matching Funds340,865
A7. Total All Funds Expended1,697,098
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs165,106
C. Total expenditures and encumbrances for direct program services1,531,992

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 0.0000 0.0000 0.0000
2. FTE Contractors 4.1810 24.5500 28.7310
3. Total FTE 4.1810 24.5500 28.7310

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 22 11.2640
2. Employees with Blindness Age 55 and Older 4 3.9400
3. Employees who are Racial/Ethnic Minorities 8 2.1570
4. Employees who are Women 34 20.2590
5. Employees Age 55 and Older 13 5.6210

C. Volunteers

8.00

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 FY413
2. Number of individuals who began receiving services in the reported FY963
3. Total individuals served during the reported fiscal year (A1 + A2) 1,376

B. Age

1. 55-59117
2. 60-64161
3. 65-69135
4. 70-74122
5. 75-79161
6. 80-84228
7. 85-89241
8. 90-94143
9. 95-9959
10. 100 & over9
11. Total (must agree with A3)1,376

C. Gender

1. Female965
2. Male411
3. Total (must agree with A3)1,376

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race20
2. American Indian or Alaska Native1
3. Asian18
4. Black or African American113
5. Native Hawaiian or Other Pacific Islander251
6. White967
7. Two or more races2
8. Race and ethnicity unknown (only if consumer refuses to identify)4
9. Total (must agree with A3)1,376

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)95
2. Legally Blind (excluding totally blind)636
3. Severe Visual Impairment645
4. Total (must agree with A3)1,376

F. Major Cause of Visual Impairment

1. Macular Degeneration721
2. Diabetic Retinopathy146
3. Glaucoma128
4. Cataracts80
5. Other301
6. Total (must agree with A3)1,376

G. Other Age-Related Impairments

1. Hearing Impairment339
2. Diabetes245
3. Cardiovascular Disease and Strokes421
4. Cancer49
5. Bone, Muscle, Skin, Joint, and Movement Disorders366
6. Alzheimer's Disease/Cognitive Impairment47
7. Depression/Mood Disorder49
8. Other Major Geriatric Concerns199

H. Type of Residence

1. Private residence (house or apartment)1,064
2. Senior Living/Retirement Community177
3. Assisted Living Facility89
4. Nursing Home/Long-term Care facility45
5. Homeless1
6. Total (must agree with A3)1,376

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)44
2. Physician/medical provider64
3. State VR agency17
4. Government or Social Service Agency161
5. Veterans Administration2
6. Senior Center169
7. Assisted Living Facility1
8. Nursing Home/Long-term Care facility11
9. Faith-based organization7
10. Independent Living center115
11. Family member or friend442
12. Self-referral280
13. Other63
14. Total (must agree with A3)1,376

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 60,121
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 282
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 322,014
1b. Total Cost from other funds 43,483
2. Provision of assistive technology devices and aids 1,074
3. Provision of assistive technology services 1,149

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 374,481
1b. Total Cost from other funds 228,183
2. Orientation and Mobility training 108
3. Communication skills 563
4. Daily living skills 816
5. Supportive services (reader services, transportation, personal 378
6. Advocacy training and support networks 292
7. Counseling (peer, individual and group) 596
8. Information, referral and community integration 842
. Other IL services 604

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 96,146
1b. Total Cost from other funds 6,457
2. Information and Referral 2,760
3. Community Awareness: Events/Activities 292 6,470

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) 987,421 1,697,099 709,678
2. Number of Individuals Served 1,197 1,381 184
3. Number of Minority Individuals Served 142 147 5
4. Number of Community Awareness Activities 247 293 46
5. Number of Collaborating agencies and organizations 117 242 125
6. Number of Sub-grantees 6 10

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 1,149 100.00%
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) 446 38.82%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 562 48.91%
B1. Number of individuals who received orientation and mobility (O & M) services 108 100.00%
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) 64 59.26%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 37 34.26%
C1. Number of individuals who received communication skills training 563 100.00%
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) 257 45.65%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 294 52.22%
D1. Number of individuals who received daily living skills training 816 100.00%
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) 403 49.39%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 409 50.12%
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) 348 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) 24 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) 14 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 189 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) 23 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 Older Independent Blind Program administered by Indiana Blind and Visually Impaired Services (BVIS) provides skills training through grant contracting with seven (7) community based programs and one (1) Orientation and Mobility independent instructor. The following networks of eight (8) contractors are utilized in delivering Older Independent Blind services: 1) Bosma Enterprises for the Blind is an Indianapolis based rehabilitation center for the visually impaired with Rehabilitation Instructors stationed in four areas of the state: Indianapolis, Valparaiso, Evansville and Lafayette. Bosma employs five Rehabilitation Instructors with defined territories covering all 92 counties in the state. Bosma contracted with a company, BrightStar, in developing a strategic outreach program. Some of the highlights of the program were training nineteen (19) outreach volunteers, a mass mailing to all ophthalmologists and optometrist in the state, new print marketing materials, and development of radio and print announcements and Public Service Announcements. Bosma’s Senior Program conducted a total of seven focus groups at senior living facilities in six different counties. 2) Access Ability is an Indianapolis based Center for Independent Living responsible for services in Boone, Hamilton, Hendricks, Marion, Hancock, Morgan, Johnson and Shelby counties providing services through one (1) Outreach Specialist, four (4) Senior Advocates and two(2) subcontractors delivering independent skills training. To increase minority outreach Access Ability networked with the Latino Resource Round Table, Indiana Minority Health Coalition, Julian Center, senior centers, assisted living facilities, and Area Agency’s on Aging. 3) The Wabash Independent Living and Learning Center is a Center for Independent Living located in Terre Haute and responsible for services in Vermillion, Parke, Putnam, Clay and Vigo counties with one Coordinator/Teacher and one Driver Assistant delivering independent skills training. Wabash hosted thirty-five (35) support group meetings and Wabash received referrals from each of the four support groups. Brochures and DVD’s have been distributed to eye clinics, local health department offices, and physician’s offices. The staff also set up a booth at two (2) minority health fairs. 4) The Independent Living Center of Eastern Indiana is a Richmond based Center for Independent Living responsible for services in Henry, Wayne, Rush, Fayette, Union, Decatur and Franklin counties with a Service Coordinator/Grant Administrator (1) and four (4) Service Coordinators providing independent skills training. The Center in collaboration with senior centers and residential retirement facilities in three counties began three (3) new low vision support groups for a total of five (5) groups. 5) The League for the Blind and Disabled is a Fort Wayne based Center for Independent Living responsible for services in Lagrange, Steuben, Noble, DeKalb, Whitley, Allen, Huntington, Wells and Adams counties with a Rehabilitation Teacher (1) and a Driver/Assistant (1) delivering independent skills training The League supports ten (10) support groups with five (5) in counties outside of Allen County. Additional outreach efforts were made by placing ads in the Hispanic owned newspaper el Mexicano. The company Briljent was contracted to target outreach efforts to the African American community. 6) ADEC is a Bristol based rehabilitation center responsible for services in LaPorte, St. Joseph, Elkhart, Marshall and Kosciusko counties. Staff consists of two Rehabilitation Teachers (2) and the Director with one clerical (1) support. ADEC‘s outreach efforts were to community centers with large African American and Hispanic populations. 7) Future Choices is a Muncie based Center for Independent Living responsible for services in Blackford, Delaware, Grant, Howard, Madison, Randolph and Tipton counties. This fiscal year was the first time this contractor was awarded Older Independent Blind funds and therefore new to the issues of developing a blind program and acquiring a trained staff knowledgeable in visual impairments and the elderly. They were awarded through a competitive process additional Orientation and Mobility training funds to outreach those underserved customers in Jennings, Dearborn, Clark, Jefferson, Switzerland, Ohio, Clinton, Carol, Tippecanoe and Warren counties. 8) A single contract was awarded to Orientation & Mobility Instructor Michael Neese for the goal of locating and providing mobility instruction to the most isolated elderly. Mr. Neese obtained his own referrals through networking in local communities.

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.

Bosma Enterprises: • Offered mental health and personal aide services to Senior Program customers. Approximately twenty (20) seniors took advantage of this program. This program provided participants with information on the grief process, adjustment to living with vision loss, and ways to deal with feelings of depression and anxiety. • Pilot program titled Bosma Connections involved seniors in interactive telephone sessions. Over 20 customers participated each day for one hour. The sessions included a low vision support group, trivia question game, a story telling hour, and an educational presentation. The educational presentations were done by interviewing professionals in the field of low vision and blindness or other fields relating to seniors. • With ARRA funding purchased a custom built mobile training unit for the purpose of expanding the Senior Program to underserved and un-served area s of the state. The mobile training unit will provide functional vision assessments, assessments for magnification and other adaptive aids, training for the use of aids, and instruction in the areas of communications, daily living skills and personal care. • Offered e-Readers to customers along with training and accessing free library downloads available through the Indiana Public Library system. • Purchased twelve (12) CCTVs that were distributed to senior living facilities in ten (10) different counties. They were placed in a common area where a number of residents with visual impairments could access the equipment.

ADEC: • Staff routinely conducts in-service trainings in the community. During the grant year 86 community awareness events were conducted. Collaborative efforts have included working with area agencies to provide information and referral services. • Collaborative efforts have included working with community centers such as the Martin Luther King Jr. center and the William Ellison Center which primary serve the African-American population in this area. Also staff has worked with LaCasa attempting to outreach to the Hispanic community. • Awareness events have occurred throughout the five (5) county catchment areas. At these events, staff discussed current trends in independent living, display and demonstrates adaptive equipment and low vision aids. Presentations were also conducted with many ophthalmologists and optometrists throughout the service area. Many of these in-services and presentations have resulted in increased awareness and increased referrals to the program. Independent Living Center of Eastern Indiana: • With the large influx of ARRA monies outreach and program expansion efforts seventeen (17) counties were served in collaboration with the Southeastern Indiana Independent Living Center located in Versailles, IN. Conducted were sixteen (16) presentations on vision aids and services to seniors in six previously un-served southeastern Indian counties. Of the 346 persons attending these presentations ninety-two (92) became consumers of Chapter II services. • Collaboration with the Minority Coalition and Richmond Lions Club increased access to African American and Hispanic communities. Working with these organization provided vision, blood sugar and hearing screenings establishing a promising base for minority outreach in the future. • The Center offers five low vision support groups which provide one hundred twenty five (125) customers with information on eye diseases, new development in assistive technology, treatment and research. Two (2) of the support groups are new and established in previously un-served counties within the grant year. • The Center expanded their services by adding 21 CCTVs to their loaner program bringing the total number to eighty-six (86). Access Ability: • Developed a Teaching Kitchen for those who want to learn how to cook, organize and operate a kitchen. It also provides an opportunity for those who simply want to learn about the options for home modifications to actually experience an accessible kitchen. The training will typically be teaching consumers how to prepare meals, manage independently in the kitchen area, identify kitchen utensils and the opportunity to learn more about adaptive appliances and equipment to make their home safer and user friendly. Some of the features of the Teaching Kitchen include: a 25.1 Cu. Ft refrigerator, countertops and flowing include Wilsonart Laminate with color coded edge and one square foot tiles in front of cabinets to orient persons with visual impairments. • Participated in Good Life Tour, Indianapolis Metropolitan Police Department Informational Fair, Senior Awareness Day, Fair Housing Conference, IUPUI Disability Awareness Fair, Senior 1000 Coalition Brunch, and Mayor’s Advisory Council on Disabilities to conduct outreach to seniors and network with other community organizations. • Conducted presentations at Carriage House of Glendale, Blue Ridge Terrace Apartments in Shelbyville, Hendricks and The League f/t Blind and Disabled: • Vision impairment talks were given to senior living complexes on visual impairments and adaptive equipment. Digital talking book equipment, large print calendars, and 20/20 pens are some of the adaptive aids that most interest the consumers. • Attend meetings of the Hispanic Social services Network. At the meetings each group represented does a short presentation on their programs. • Google’s Translation Tool is used for the League’s blog, web site and Disability Information Site. This tool converts the information into 35 different languages including Spanish. • Ads were developed and appeared in the El Mexicano, Hispanic owned newspaper beginning in October 201o and running through September 2011. • Briljent, a woman owned business, targeted outreach activities for the African American population. • To serve those that reside in rural areas the League offers four support groups: Angola Support Group in Steuben County, Auburn Support Group in Dekalb county, Decatur Support Group in Adams county and LaGrange Support Group in La Grange county.

The Wabash Independent Living Center: • Collaborated with the Sullivan county regional Lions club in launching a sight loss support group meeting in the city of Sullivan. • Provided services information to city administrations, county health departments, Area Agencies on Aging, Vocational Rehabilitation Services, Veterans Administration, eye clinics, public libraries, local Lion’s Clubs, media outlets, senior program managers, and the Independent Living Center serving the southern seven counties. • Collaborated with Easter Seals Crossroads to ensure the latest technology is available to consumers. The Chapter 2 Program Manager serves on the advisory board of the Easter Seals Crossroads INDATA project. • Participated in the Indiana AER conference. During the conference staff participated in workshops receiving a combined total of 8.75 continuing education hours.

Future Choices: • This was a start up year in which Future Choices received their first OIB grant award began with no consumers. • Expanded into nine (9) counties in which there were outreach services in peer to peer counseling, independent living skills training, purchase of participant aids and technology, adjust me to vision loss, mobility instruction, recreation, and socialization.

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.

Total Number of Surveys Completed for FY 2010-2011: 428 1. I feel confident in my ability to live independently? 1. Strongly Agree………………………………Number: 169 2. Agree………………………………………......Number: 184 3. Disagree……………………………………....Number: 63 4. Strongly Disagree………………………….Number: 12

2. I have considered moving to a nursing home or assisted living because of my vision. 1. Agree……………………………………………Number: 128 2. Disagree……………………………………….Number: 300

3. As a result of training, I will be more capable of remaining in my home. 1. Strongly Agree………………………………...Number: 163 2. Agree……………………………………………….Number: 225 3. Disagree……………………………………………Number: 34 4. Strongly Disagree………………………………Number: 6

4. As a result of training, I am able to travel more independently. 1. Strongly Agree………………………………………………..Number: 58 2. Agree………………………………………………………………Number: 170 3. Disagree………………………………………………………….Number: 51 4. Strongly Disagree…………………………………………….Number: 28 5. Was never an issue to me prior to services……. Number: 121 5. As a result of training, I am able to read and manage my paperwork (e.g. mail, check writing, and correspondence)? 1. Strongly Agree………………………………………………….Number: 166 2. Agree………………………………………………………………..Number: 135 3. Disagree…………………………………………………………….Number: 53 4. Strongly Disagree………………………………………………Number: 5 5. Was never an issue with me prior to service…….Number: 41

6. As a result of training, I am better able to take care of my personal needs like grooming, cooking, laundry, medication control, etc? 1. Strongly Agree……………………………………………………Number: 122 2. Agree……………………………………………......................Number: 191 3. Disagree……………………………………………………………..Number: 28 4. Strongly Disagree………………………………………………..Number: 13 5. Was never an issue with me prior to services……..Number: 71

7. As a result of this training, I am less dependent on others? 1. Strongly Agree…………………………………………………….Number: 174 2. Agree…………………………………………………………………..Number: 188 3. Disagree……………………………………………………………….Number: 38 4. Strongly Disagree………………………………………………….Number: 3 5. Was never an issue with me prior to services……...Number: 25 8. As a result of this training, I am better able to participate with family, friends, and community life? 1. Strongly Agree………………………………………………………Number: 154 2. Agree…………………………………………………………………...Number: 209 3. Disagree……………………………………………………………….Number: 25 4. Strongly Disagree………………………………………………….Number: 4 5. Was never an issue with me prior to services……...Number: 36

9. As a result of training, you were able to meet all the goals you wanted to accomplish? 1. Strongly Agree……………………………………..Number: 175 2. Agree……………………………………………………Number: 212 3. Disagree……………………………………………….Number: 37 4. Strongly Disagree………………………………….Number: 4

10. Would you recommend this program to others? 1. Strongly Agree……………………………………..Number: 278 2. Agree……………………………………………………Number: 139 3. Disagree……………………………………………….Number: 9 4. Strongly Disagree…………………………………Number: 2

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).

Mrs. M who lives in a rural area un-served by public transportation acquired a Beecher Telescopic System completed her driver’s training and received her license. She can drive up to ten miles from her home which allows her to go to the grocery, church, and community and family activities. She is elated at the freedom that she has regained to go where she wants without depending on others. Mrs. M was very fearful when she began this whole process and it was only the support and encouragement of peers in the low vision support group that made it possible for her to complete her lessons and pass her driving test at age 79. Mrs. P, a legally blind 83 year old amputee with a prosthetic leg lives alone on the family farm since her husband’s recent death. Her children, concerned about her well being, doubted she could live alone safely. With the Older Independent Blind program’s assistance her appliances were marked with bump dots and a mini-grant providing a talking microwave, liquid level indicator, large print measuring cups, talking clocks, a big button phone, and a 5X magnifier. With these devices she is able to function very independently once again and her children feel better about her living alone.

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

The majorities of the older blind are on fixed incomes and cannot afford to purchase many of the low vision and adaptive aids required to maintain home and community independence. Transportation resources are very limited in the underserved rural counties making it difficult for individuals to travel to doctor visits, grocery trips, peer support meetings, visiting families and other routine destinations. Indiana population is aging with visual problems increasing. Indiana will see the senior population escalate 90% by 2040 (1 in 5 Hoosiers will be 65+). The elderly demographic will increase from the current 12% (65+) to a 21% share of the state’s population as the share of all other age groups decline. This has economic and policy implications for the future operations and management of the program.

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 byLocket Phillips
TitleManager of Blind Services
Telephone317-232-1441
Date signed12/19/2011