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

RSA-7-OB for Arkansas Division of Services for the Blind - H177B120004 report through September 30, 2012

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year316,192
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year160,806
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2193,300
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)38,620
A4. Third party0
A5. In-kind74,244
A6. Total Matching Funds112,864
A7. Total All Funds Expended306,164
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs5,499
C. Total expenditures and encumbrances for direct program services300,665

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 0.0500 0.0000 0.0500
2. FTE Contractors 1.7500 3.0000 4.7500
3. Total FTE 1.8000 3.0000 4.8000

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 4 0.0000
2. Employees with Blindness Age 55 and Older 1 0.0000
3. Employees who are Racial/Ethnic Minorities 2 0.0250
4. Employees who are Women 9 0.0500
5. Employees Age 55 and Older 7 0.0500

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 FY455
2. Number of individuals who began receiving services in the reported FY121
3. Total individuals served during the reported fiscal year (A1 + A2) 576

B. Age

1. 55-5946
2. 60-6460
3. 65-6959
4. 70-7470
5. 75-7972
6. 80-8498
7. 85-8997
8. 90-9456
9. 95-9914
10. 100 & over4
11. Total (must agree with A3)576

C. Gender

1. Female392
2. Male184
3. Total (must agree with A3)576

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race5
2. American Indian or Alaska Native2
3. Asian1
4. Black or African American130
5. Native Hawaiian or Other Pacific Islander0
6. White435
7. Two or more races3
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)576

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)55
2. Legally Blind (excluding totally blind)373
3. Severe Visual Impairment148
4. Total (must agree with A3)576

F. Major Cause of Visual Impairment

1. Macular Degeneration279
2. Diabetic Retinopathy79
3. Glaucoma91
4. Cataracts30
5. Other97
6. Total (must agree with A3)576

G. Other Age-Related Impairments

1. Hearing Impairment111
2. Diabetes156
3. Cardiovascular Disease and Strokes210
4. Cancer62
5. Bone, Muscle, Skin, Joint, and Movement Disorders214
6. Alzheimer's Disease/Cognitive Impairment99
7. Depression/Mood Disorder18
8. Other Major Geriatric Concerns184

H. Type of Residence

1. Private residence (house or apartment)491
2. Senior Living/Retirement Community50
3. Assisted Living Facility15
4. Nursing Home/Long-term Care facility15
5. Homeless5
6. Total (must agree with A3)576

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)110
2. Physician/medical provider31
3. State VR agency13
4. Government or Social Service Agency65
5. Veterans Administration11
6. Senior Center20
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization0
10. Independent Living center9
11. Family member or friend179
12. Self-referral122
13. Other16
14. Total (must agree with A3)576

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 45,550
1b. Total Cost from other funds 4,244
2. Vision screening / vision examination / low vision evaluation 12
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 3

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 0
1b. Total Cost from other funds 6,000
2. Provision of assistive technology devices and aids 56
3. Provision of assistive technology services 63

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 119,251
1b. Total Cost from other funds 102,620
2. Orientation and Mobility training 112
3. Communication skills 81
4. Daily living skills 130
5. Supportive services (reader services, transportation, personal 12
6. Advocacy training and support networks 87
7. Counseling (peer, individual and group) 8
8. Information, referral and community integration 41
. Other IL services 72

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 23,000
1b. Total Cost from other funds 0
2. Information and Referral 137
3. Community Awareness: Events/Activities 31 82

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) 196,010 306,164 110,154
2. Number of Individuals Served 582 576 -6
3. Number of Minority Individuals Served 137 141 4
4. Number of Community Awareness Activities 19 31 12
5. Number of Collaborating agencies and organizations 11 12 1
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 63 100.00%
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) 51 80.95%
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 112 100.00%
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) 112 100.00%
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 81 100.00%
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) 81 100.00%
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 130 100.00%
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) 130 100.00%
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) 104 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) 26 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) 0 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 October 2012. 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 two 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 access to an array of local services for the ever growing population of older blind consumers, by taking advantage of the extensive network of civic and other support groups aligned with WSB, but operating from a community base.

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.

Arkansas Division of Services for the Blind (DSB) contracts with The National Research and Training Center (NRTC) on Blindness and Low Vision at Mississippi State University to provide a program evaluation of its OIB program. As part of the evaluation, consumers closed from the program after receiving services are interviewed about their experiences with the program. DBS has a contractual agreement with World Services for the Blind to provide IL services to consumers eligible under the Title VII, Chapter 2 program. World Services provides names of closed consumers and the NRTC Project Director and another experienced telephone interviewer contacts consumers to complete surveys. The NRTC then prepares a program evaluation report that includes consumers’ feedback regarding satisfaction with services and how services have impacted their ability to live independently. In addition, pre-and post functional data on all consumers served, demographic and service data from the annual 7-OB report, and findings from an on-site review of the program are included in the final report. The following provides demographic and outcome data from telephone interviews with closed consumers conducted in federal fiscal year 2012.

Most respondents (67%) were 75 years of age or older. More than two-thirds (69%) were female. About 85% of participants reported living in a private residence; the others living in senior living/retirement communities. The majority of the respondents (52%) reported macular degeneration as the reason for their vision loss; the second reported reason for vision loss was glaucoma—19% of respondents indicated they had glaucoma; 78% reported having other health conditions in addition to vision loss. Consumer satisfaction levels among those participating in the survey were high. In responding to satisfaction questions regarding delivery of services, i.e., manner of service delivery, types of services provided, and perceived outcomes of services—almost all of the participants expressed satisfaction. Participants were most satisfied with the timeliness of services (96%); attentiveness, concern, and interest of staff (96%); followed by the overall quality of services (87%).

Consumers responded to questions about IL services related to their ability to travel safely and independently in their home and/or community, communication skills, daily living skills, their perceptions of control and confidence in maintaining their living situations, and how devices and equipment had impacted their ability to engage in life activities. For each of these questions, consumers were asked if they felt they experienced an improvement, no change, or a decrease in their level of functioning because of receiving services. If they did not receive/request a service, they indicated so on the respective question. Note that percentages may not total 100% due to rounding. • Among consumers receiving devices or equipment, 71% indicated that devices had improved their ability to engage in customary life activities, 10% reported devices had helped them maintain their ability, and 19% reported that they were not using any of the devices or equipment provided by the program. • When asked about their ability to travel in the home and community, 22% of consumers reported they were better able to travel in their home and/or community, 7% reported no change, 0% reported being less able, and 70% reported not receiving/requesting the service. • When asked about training to improve communication skills, 26% reported that they were now able to function more independently, 11% reported they had maintained their ability to function more independently, 0% reported a decline, and 63% indicated that they did not receive/request communication services. • When asked about their ability to perform daily living skills activities such as food preparation, grooming and dressing, medical management, shopping etc., 15% of consumers reported being better able to perform daily living skills, 4% reported no change, 0% reported a decline, and 82% reported not receiving/requesting the service. • When asked about functioning before services, 80% indicated they now have greater control and confidence in their ability to maintain their current living situation, 20% reported no change, and 0% indicated feeling less control and confidence. • When asked about changes in lifestyle, only one respondent indicated a recent change in his/her living situation.

A copy of the complete program evaluation report conducted by the NRTC will be available after its completion in early 2013.

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).

Contracted services has assisted 6 clients with O&M in new environments which included counseling for those leaving their homes. Assisted individuals from hospital to new living arrangements. Taught 14 people to prepare simple meals in crockpots to remain independent. Issued 15 iPads and provided 9 hours technical training at the center. Provided Braille training to 6 clients at the center. Provided training in the regional area to ensure all clients have access to training.

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

This greatest problem is with funding as it is with everyone, but acquisition and retention of qualified staff is also a growing concern because of the declining availability of academic programs nationwide.

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
Telephone(501) 682-0360
Date signed12/30/2012