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

RSA-7-OB for Maine Division for the Blind and Visually Impaired - H177B110019 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 year76,301
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2225,000
A2. Total other federal144,000
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement144,000
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)219,000
A4. Third party0
A5. In-kind240,000
A6. Total Matching Funds459,000
A7. Total All Funds Expended828,000
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs97,000
C. Total expenditures and encumbrances for direct program services731,000

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 0.6000 4.0500 4.6500
2. FTE Contractors 1.1000 4.9500 6.0500
3. Total FTE 1.7000 9.0000 10.7000

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 7 2.3500
2. Employees with Blindness Age 55 and Older 1 0.2500
3. Employees who are Racial/Ethnic Minorities 2 1.0000
4. Employees who are Women 22 10.0500
5. Employees Age 55 and Older 10 4.1000

C. Volunteers

2.00

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 FY154
2. Number of individuals who began receiving services in the reported FY144
3. Total individuals served during the reported fiscal year (A1 + A2) 298

B. Age

1. 55-5913
2. 60-6426
3. 65-6926
4. 70-7413
5. 75-7935
6. 80-8442
7. 85-8964
8. 90-9460
9. 95-9915
10. 100 & over4
11. Total (must agree with A3)298

C. Gender

1. Female217
2. Male81
3. Total (must agree with A3)298

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race0
2. American Indian or Alaska Native1
3. Asian0
4. Black or African American2
5. Native Hawaiian or Other Pacific Islander0
6. White295
7. Two or more races0
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)298

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)4
2. Legally Blind (excluding totally blind)111
3. Severe Visual Impairment183
4. Total (must agree with A3)298

F. Major Cause of Visual Impairment

1. Macular Degeneration165
2. Diabetic Retinopathy20
3. Glaucoma26
4. Cataracts3
5. Other84
6. Total (must agree with A3)298

G. Other Age-Related Impairments

1. Hearing Impairment29
2. Diabetes53
3. Cardiovascular Disease and Strokes58
4. Cancer13
5. Bone, Muscle, Skin, Joint, and Movement Disorders29
6. Alzheimer's Disease/Cognitive Impairment18
7. Depression/Mood Disorder24
8. Other Major Geriatric Concerns84

H. Type of Residence

1. Private residence (house or apartment)213
2. Senior Living/Retirement Community19
3. Assisted Living Facility23
4. Nursing Home/Long-term Care facility12
5. Homeless31
6. Total (must agree with A3)298

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)68
2. Physician/medical provider10
3. State VR agency8
4. Government or Social Service Agency26
5. Veterans Administration0
6. Senior Center2
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization3
10. Independent Living center27
11. Family member or friend39
12. Self-referral82
13. Other33
14. Total (must agree with A3)298

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 10,000
2. Vision screening / vision examination / low vision evaluation 298
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 0
1b. Total Cost from other funds 15,000
2. Provision of assistive technology devices and aids 298
3. Provision of assistive technology services 298

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 301,301
1b. Total Cost from other funds 404,699
2. Orientation and Mobility training 298
3. Communication skills 298
4. Daily living skills 298
5. Supportive services (reader services, transportation, personal 27
6. Advocacy training and support networks 135
7. Counseling (peer, individual and group) 119
8. Information, referral and community integration 150
. Other IL services 0

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 37
3. Community Awareness: Events/Activities 15 163

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) 849,026 828,000 -21,026
2. Number of Individuals Served 405 298 -107
3. Number of Minority Individuals Served 2 3 1
4. Number of Community Awareness Activities 17 15 -2
5. Number of Collaborating agencies and organizations 8 8 0
6. Number of Sub-grantees 1 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 298 100.00%
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) 271 90.94%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 27 9.06%
B1. Number of individuals who received orientation and mobility (O & M) services 298 100.00%
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) 288 96.64%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 10 3.36%
C1. Number of individuals who received communication skills training 298 100.00%
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) 292 97.99%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 7 2.35%
D1. Number of individuals who received daily living skills training 298 100.00%
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) 270 90.60%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 19 6.38%
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) 37 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) 3 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) 5 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 6 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) 6 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 Division for the Blind & Visually Impaired (DBVI) implements its IL-Older Blind program through the use of in-house staff to include Orientatin & Mobility Instructors, Vision Rehabilitation Therapists, and Low Vision Therapists and through the use of a sub-grantee/contractor, the Iris Network. Some of the services provided by the Iris Network are some Vision Rehabiliation Therapy, Personal Adjustment Counseling, some Orientation and Mobility instruction and some intake services.

The recent census confirmed the very small percentage of minority groups in Maine. In the larger cities, outreach is being done for Asian, Middle Eastern, Spanish-speaking, French Canadian, African, and other minority groups. In Lewiston, Somalis are being served in the Lewiston CareerCenter with an interpreter who works for the Center. The French Canadian community in Lewiston has also been served for many years by staff interpreting for that population. In addition, DBVI continues to maintain ongoing communications with the four Maine tribes of Native Americans:

Passamaquoddy Tribe Penobscot Indian Nation Houlton Band of Maliseets Aroostook Band of Micmac Indians

DBVI has a representative from the American Indian Vocational Rehabilitation Services on the DBVI State Rehabilitation Council.

The Division continues to work with the Native American health centers doing outreach for all of our programs. These centers, managed by each of the tribes in Maine, have served as a contact point and focus for outreach efforts by the Division.

Discussions continue in an effort to provide information about the Divisions programs in the Health Center newsletter that goes to all of the registered Penobscot tribal members on and off the island.

The process is based upon a plan which identifies the achievement of independent living goals which will enable an individual who is blind or has low vision to secure a level of independent living consistent with his or her current interests, capacities and abilities. Services provided to individuals who are blind or visually impaired must be necessary and must be provided as cost effectively as possible

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.

DBVI is involved in numerous activities throughout the state to expand or improve IL services to the older blind population. Some of these activities are working collaboratively with doctors to improve the referral process so consumers are aware of DBVI’s services; working with the state’s Veterans Administration (VA) to improve services for older veterans who are blind or have low vision and participating in health fairs around the state.

In addition, DBVI entered a collaborative partnership with the Division for the Deaf Hard of Hearing and Late-Deafened, the University of Southern Maine Linguistics Program, The Iris Network, Helen Keller National Center, and consumers with dual sensory impairment to develop a professional training program for Interpreters fo people who are deaf-blind, and to create and build a volunteer Support Service Provider (SSP) program. To date, we have trained over 20 professional Deaf-blind Interpreters, have trained over 35 volunteer SSP’s, and have approximately 15 individuals who are deaf-blind or dual sensory impaired accessing these services.

DBVI utilized the last of the ARRA IL funds during this fiscal year. The Community Connections project continued to soar. The project coordinator worked to enhance activities with therapeutic components and increase the involvement of vision rehabilitation professionals to provide therapeutic services as part of these activities. Some of her activities included: presenting to the Aging with Grace group regarding updates in Community Connections and upcoming events; contacting the Lion’s Club regarding information booths at their annual convention; setting up a Community Connections booth at the National Multiple Sclerosis Society Health and Wellness Fair; and facilitated various Visually Impaired Persons (VIP) groups around the state.

DBVI also used some ARRA IL funds to redesign its comprehensive statewide low vision delivery system, which will benefit older individuals who are blind or visually impaired. This system, in addition to being more cost-effective, will insure that professional staff involved in providing low vision rehabilitation services are all highly trained in this field. Low vision kits have been put together by a group that focused on the needs of those individuals with low vision and the kits will be dispersed around the state once the protocol for the delivery of these aids and appliances is in place.

Currently the DBVI State Rehabilitation Council (SRC) has a representative that has been attending the State Independent Living Council (SILC) to represent the division. This individual is seeking gubernatorial appointment. This representation allows the division to stay current with efforts to expand or improve IL services as well as participate in the various activities throughout the state.

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.

DBVI uses a sub-grantee for a large portion of the IL-Older Blind program. They use a survey instrument with questions (and/or statements that require the consumer to attach a number representing the level of satisfaction) that measure consumer satisfaction and collects demographic data (optional). The questions measure the consumer’s level of satisfaction as it pertains to courtesy of staff, availability of informed choice and decision making, timeliness of servces and overall satisfaction with the quality of services that he/she received.

During the period of 1/10 through 12/10, one hundred and twenty-six surveys were sent out and fifty-three were completed and returned. Of those, they all reported that they felt they were treated with courtesy and respect; forty-four felt that they were informed that they had choices in their plan of service; forty-eight played an active role in decision making; forty-nine felt that services were provided in an acceptable timeframe; and fifty responded that they are overall satisfied with the quality of services that were received. Below is a list of the questions:

1. The agency staff that worked with me treated me with courtesy and respect. 2. I was informed that I had choices in the development of my plan of service. 3. I had an active role in deciding what services I would receive. 4. Services were provided within a timeframe that was acceptable to me. 5. My specific needs were addressed during my training. comments: 6. Overall I am satisfied with the quality of the services that I received from Iris. 7. What was the greatest difference this program made in your life? comments: There were a number of comments received in response to this question. Here is a sample of them:

“Helped me as far as they could and helped me understand.” “Graduating High school” “Increased my independence” “Showing us tricks to help with daily living tasks, i.e. threading the sewing machine, adjusting lighting, received floor lamp. They can take my kids before my lamp —invaluable” “Showed me how to use household appliances” “Everything they did was really good” “She doesn’t remember visit, still here and making out okay” “Adaptive devices were really helpful” “Being told about CCTV. Going to low vision clinic that she read about in our newsletter” “I just loved having her come to see me. Radio is great so I can hear the paper being read. Device for the TV helps also.” “Real pleased with everything” “They boosted my spirits and encouraged me to be more positive” “Gave me equipment and some suggestions and ideas” (There was a problem getting transportation to services in Bangor.) “She helped me to read with different equipment — also her encouragement” “House aids for oven, washing machine/dryer, extra lights, and magnifier”

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).

Case 1

A very lovely 89 year old woman has worked with the Division For The Blind & Visually Impaired for approximately ten years now — at different intervals. Her eye condition is Macular Degeneration and her most difficult challenge is reading. She is very motivated and enthusiastic about life in general and she is also eager to try different low vision devices and techniques.

She has most recently received a low vision exam and she has received several hand held magnifiers, which have been of some assistance. She came into the Presque Isle Career Center and experimented a bit with an electronic magnifier (CCTV) and she found it to be, in her words, overwhelming. She had no interest in trying different models of electronic magnifiers; she was quite sure she wanted to use something more transportable and less complicated.

The Division For The Blind & Visually Impaired provided her with a 2X stand craft magnifier, which she liked very, very much. She was able to put her reading material under the magnifying lens, which also has LED lighting. The stand craft magnifier is also very portable, as well as easy to manipulate and adjust.

She was assured that should she desire to pursue other low vision aids and possibilities, she could call this agency at any time. This lady is a fine example of maintaining independence within her home by seeking out the equipment and training that best suits her needs and her comfort.

She received low vision services, adaptive equipment and low vision training.

Case 2

This woman resides in an assisted living center, where she has her own apartment, furnished with her personal furnishings and other items from her home. Her eye conditions are Age Related Macular Degeneration and well controlled Glaucoma. She is ninety-four years old and very active. Our Low Vision Consultant worked with her in regard to her ability to read print. This woman received several items, including a talking clock, large print calendar, and stand task magnifier. Should she need further services, she has been encouraged to contact this agency.

In summary, this individual received Low Vision Assessment, Low Vision training, and adaptive equipment.

Case 3

A pleasant ninety-two year old gentleman was first introduced to us as a Blind VR client about ten years ago. He lived with his wife, who did most of the daily living tasks for herself and for him. He indicated very little need for our services at that time, since his wife took care of everything, in his words. In the midst of his involvement with DBVI, his wife became very ill and passed away. This gentleman was left to fend for himself and it became apparent to him and to those working with him that he was in great need of training. He was closed successfully.

Approximately one year ago, this gentleman contacted us to inquire about additional needs. He was opened under the Independent Living program and received a large button phone, talking watch, large print calendar, bold lined paper and 20/20 markers. In addition to that, our Orientation and Mobility Specialist worked with him in regard to some mobility needs, including instruction for safe travel along a familiar route that he traveled daily. Once his needs were met, he was closed under the Independent Living caseload. He was assured that should further needs arise, he would be reopened and services would be administered once again.

This gentleman received adaptive equipment and mobility training.

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

The state of Maine has an increasing population of the individuals over the age of 55. According to recent data from the American Community Survey (ACS), more than 60% of Maine’s population that is eligibile for DBVI services falls into that age category. The dilemna is that the resources fall well below the need for independent living services for the older blind population.

Maine is such a rural state that transportation continues to be an issue for consumers in the IL-Older Blind program. These consumers find it difficult to find transportation in order to attend appointments and other support group activities. The Communities Connection Coordinator has done a great job of researching the various community activities and support groups but DBVI has found that consumers are still finding it difficult to get transportation to and from these events.

An increase in the Title VII-Chapter 2 grant would allow Maine to provide services for a greater number of consumers and allow them the opportunity to maintain their independence and increase the quality of life in their communities.

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 byJohn M. McMahon
TitleDirector, DBVI
Telephone207-623-7949
Date signed12/28/2011