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

RSA-7-OB for Louisiana Rehabilitation Services - H177B110018 report through September 30, 2011

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year449,972
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 24,499,720
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)0
A4. Third party0
A5. In-kind49,997
A6. Total Matching Funds49,997
A7. Total All Funds Expended4,549,717
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs0
C. Total expenditures and encumbrances for direct program services4,549,717

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 0.3600 0.0000 0.3600
2. FTE Contractors 3.8500 11.3100 15.1600
3. Total FTE 4.2100 11.3100 15.5200

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 10 0.3000
2. Employees with Blindness Age 55 and Older 2 0.4200
3. Employees who are Racial/Ethnic Minorities 10 1.7600
4. Employees who are Women 22 5.4700
5. Employees Age 55 and Older 6 1.7200

C. Volunteers

0.00

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 FY253
2. Number of individuals who began receiving services in the reported FY1,441
3. Total individuals served during the reported fiscal year (A1 + A2) 1,694

B. Age

1. 55-59162
2. 60-64132
3. 65-69200
4. 70-74229
5. 75-79271
6. 80-84294
7. 85-89271
8. 90-9489
9. 95-9943
10. 100 & over3
11. Total (must agree with A3)1,694

C. Gender

1. Female1,061
2. Male633
3. Total (must agree with A3)1,694

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race10
2. American Indian or Alaska Native6
3. Asian3
4. Black or African American489
5. Native Hawaiian or Other Pacific Islander0
6. White1,177
7. Two or more races9
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)1,694

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)184
2. Legally Blind (excluding totally blind)1,146
3. Severe Visual Impairment364
4. Total (must agree with A3)1,694

F. Major Cause of Visual Impairment

1. Macular Degeneration866
2. Diabetic Retinopathy258
3. Glaucoma221
4. Cataracts87
5. Other262
6. Total (must agree with A3)1,694

G. Other Age-Related Impairments

1. Hearing Impairment467
2. Diabetes447
3. Cardiovascular Disease and Strokes336
4. Cancer148
5. Bone, Muscle, Skin, Joint, and Movement Disorders332
6. Alzheimer's Disease/Cognitive Impairment118
7. Depression/Mood Disorder56
8. Other Major Geriatric Concerns237

H. Type of Residence

1. Private residence (house or apartment)1,186
2. Senior Living/Retirement Community281
3. Assisted Living Facility138
4. Nursing Home/Long-term Care facility89
5. Homeless0
6. Total (must agree with A3)1,694

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)495
2. Physician/medical provider93
3. State VR agency31
4. Government or Social Service Agency26
5. Veterans Administration70
6. Senior Center42
7. Assisted Living Facility10
8. Nursing Home/Long-term Care facility9
9. Faith-based organization20
10. Independent Living center48
11. Family member or friend379
12. Self-referral401
13. Other70
14. Total (must agree with A3)1,694

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 136,780
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 930
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 212,402
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 1,576
3. Provision of assistive technology services 952

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 133,204
1b. Total Cost from other funds 0
2. Orientation and Mobility training 423
3. Communication skills 934
4. Daily living skills 871
5. Supportive services (reader services, transportation, personal 239
6. Advocacy training and support networks 626
7. Counseling (peer, individual and group) 994
8. Information, referral and community integration 409
. Other IL services 12

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 393
3. Community Awareness: Events/Activities 147 2,558

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) 1,252,858 0 -1,252,858
2. Number of Individuals Served 2,040 1,694 -346
3. Number of Minority Individuals Served 498 517 19
4. Number of Community Awareness Activities 127 147 20
5. Number of Collaborating agencies and organizations 42 49 7
6. Number of Sub-grantees 3 3

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 952 100.00%
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) 1,090 114.50%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 290 30.46%
B1. Number of individuals who received orientation and mobility (O & M) services 423 100.00%
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) 291 68.79%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 155 36.64%
C1. Number of individuals who received communication skills training 934 100.00%
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) 741 79.34%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 213 22.81%
D1. Number of individuals who received daily living skills training 871 100.00%
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) 617 70.84%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 263 30.20%
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) 576 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) 16 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) 40 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 66 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) 36 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.

Louisiana Rehabilitation Services provides services to older blind consumers across the state through three contractors who provide services on a regional basis. The contractors are the Louisiana Center for the Blind in Ruston, the Affiliated Blind of Louisiana Training Center in Lafayette, and the Lighthouse for the Blind in New Orleans. They are located in the north central, southwest, and southeastern regions of the state respectively.

Each contractor provides small group and individualized instruction, depending on the individual and their unique needs. Each contractor also provides low vision evaluations and provision of recommended low vision and other AT devices. In addition, each contractor provides information and referral services as needed, as well as advocacy skills training, etc.

In recent years, there has also been a concerted effort to reach traditionally unserved or under served populations. As a result of this, contractors engage in activities such as health fairs; obtaining media exposure through talk shows, commercials, newspaper articles, etc.; as well as, working collaboratively with other agencies/organizations such as the VA.

The Louisiana Center for the Blind’s mobile unit known as MATES (Mobile Assessment and Training Environment for Seniors) was completed in September of 2010. The unit is a 36 foot ADA accessible motor coach which has been adapted to serve as a mobile training facility for consumers of older blind services, particularly in the most rural areas of the state.

The Mobile unit also functions as a source of information and education. It has been driven to health fairs, senior centers, churches, and other statewide programs for seniors to educate the public about vision loss and services available for the blind.

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.

Our contractors have engaged in the following activities to promote older blind services:

Continued work with VA to accept and to make referrals of consumers as appropriate. Collaborated with several universities to accept interns in low vision related fields. 14 plus presentations to staff of home health clinics, rural health clinics, councils on aging, and other groups. Partnerships with 20 plus ophthalmologists around the state to conduct low vision evaluations and for the purpose of obtaining referrals Presentations to state/national optometrist/ophthalmologists associations. Multiple presentations to consumers at councils on aging, health fairs, etc. Participation in local observations of events such as National White Cane Day and “Meet the Blind month.” 5 plus newspaper articles featuring older blind services and/or individuals Radio and TV commercials/appearances All contractors have developed and/or maintained accessible web sites.

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.

Each contractor performs their own consumer satisfaction survey. In addition to this, I, as the program manager do follow-up calls with randomly selected consumers, and do contract monitoring, including review of consumer files, with each contractor. Louisiana traditionally has a very high degree of consumer satisfaction with older blind services, as most recent information indicates approximately 96% consumer satisfaction. In general, negative comments are usually based on the consumer’s disappointment with equipment-disappointment with the field of view they have when using the magnifier that worked best for them.

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).

Consumer 1 was one of the first individuals seen in an all new Mobile Assessment and Training Environment for Seniors, (MATES unit). The primary focus of the MATES unit is to go to the most rural areas of our state. Mrs. J. lives in a very rural area of the state, nearly an hour away from the nearest healthcare facility.

She had been blind for almost 10 years, but had never received any training or services, and did not know there was anything available for her. In fact, her family pushed her around in a wheel chair, as they were afraid for her to walk due to her blindness. She had quit cooking and really had become very dependent on her family.

She received a cane, along with orientation and mobility training, and no longer uses the wheel chair. She also underwent daily living skills training, and is now preparing her own meals. Mrs. J also received assistive technology and training and is now comfortable independently dialing the phone, as well as operating the equipment to listen to recorded books. Staff worked with both the consumer and/or her family through this process. The consumer indicated she feels as if "a whole new world has opened up" to her.

Consumer 2, who is 56, lives alone. He reported that he and his wife “split up” due to his visual impairment and resulting strain on their marriage due to his inability to continue earning an income. Prior to age 55, he received Independent Living Part B services, but indicated he was relieved to know that there were additional services available to him. He appeared to desire and strives for independence, and had the support of his children.

He underwent a low vision evaluation, as well as both home-based and small group training. Prior to receiving training on kitchen safety, Mr. X indicated he had a very close call with a house fire, which resulted from his measuring ingredients near an open flame on his stove. He was trained on kitchen safety, and has reported no further incidents.

Consumer requested that his appliances be tactually marked, and additional lighting was provided to him. For a period of time, he contacted staff almost daily to request additional information on specified areas of training; therefore, follow-up training was provided, and he is now very independent.

He is now doing well in his home, and regularly cooks for his family.

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

As services are provided by three contractors on a regional basis, the most difficulty lies in ensuring the continuity of services across the state. Fortunately, all contractors offer a version of home-based, as well as small group instruction. All contractors also offer low vision services, advocacy training, provision of AT devices, etc.

There also exists the concern with efficient and timely service delivery to individuals who live in rural areas. In the past several years, we have made a concerted effort to decrease the amount of time between the referral and the initial face-to-face meeting. The average amount of time lapse has been decreasing, and is now less than 30 days.

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 byCharles Kevin Monk
TitleBlind Services Executive Director
Telephone225-219-2943
Date signed12/21/2011