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

RSA-7-OB for Florida Division of Blind Services - H177B120057 report through September 30, 2012

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year2,295,562
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year49,115
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 22,344,677
A2. Total other federal454,557
(a) Title VII-Chapter 1-Part B172,687
(b) SSA reimbursement281,870
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)1,350,234
A4. Third party833,856
A5. In-kind468,659
A6. Total Matching Funds2,652,749
A7. Total All Funds Expended5,451,983
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs1,570,970
C. Total expenditures and encumbrances for direct program services3,881,013

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 1.0000 0.0000 1.0000
2. FTE Contractors 48.1500 92.5600 140.7100
3. Total FTE 49.1500 92.5600 141.7100

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 40 21.6500
2. Employees with Blindness Age 55 and Older 17 6.2900
3. Employees who are Racial/Ethnic Minorities 49 37.4700
4. Employees who are Women 187 122.1200
5. Employees Age 55 and Older 80 53.2900

C. Volunteers

28.00

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 FY1,056
2. Number of individuals who began receiving services in the reported FY2,056
3. Total individuals served during the reported fiscal year (A1 + A2) 3,112

B. Age

1. 55-59252
2. 60-64283
3. 65-69273
4. 70-74275
5. 75-79371
6. 80-84530
7. 85-89591
8. 90-94393
9. 95-99125
10. 100 & over19
11. Total (must agree with A3)3,112

C. Gender

1. Female2,099
2. Male1,013
3. Total (must agree with A3)3,112

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race252
2. American Indian or Alaska Native9
3. Asian21
4. Black or African American430
5. Native Hawaiian or Other Pacific Islander3
6. White2,390
7. Two or more races7
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)3,112

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)197
2. Legally Blind (excluding totally blind)1,978
3. Severe Visual Impairment937
4. Total (must agree with A3)3,112

F. Major Cause of Visual Impairment

1. Macular Degeneration1,573
2. Diabetic Retinopathy263
3. Glaucoma582
4. Cataracts45
5. Other649
6. Total (must agree with A3)3,112

G. Other Age-Related Impairments

1. Hearing Impairment237
2. Diabetes102
3. Cardiovascular Disease and Strokes207
4. Cancer19
5. Bone, Muscle, Skin, Joint, and Movement Disorders67
6. Alzheimer's Disease/Cognitive Impairment7
7. Depression/Mood Disorder32
8. Other Major Geriatric Concerns202

H. Type of Residence

1. Private residence (house or apartment)2,592
2. Senior Living/Retirement Community267
3. Assisted Living Facility196
4. Nursing Home/Long-term Care facility54
5. Homeless3
6. Total (must agree with A3)3,112

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)643
2. Physician/medical provider95
3. State VR agency73
4. Government or Social Service Agency322
5. Veterans Administration29
6. Senior Center79
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization12
10. Independent Living center0
11. Family member or friend586
12. Self-referral908
13. Other365
14. Total (must agree with A3)3,112

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 175,228
1b. Total Cost from other funds 232,278
2. Vision screening / vision examination / low vision evaluation 1,992
3. Surgical or therapeutic treatment to prevent, correct, or modify disabling eye conditions 1

B. Assistive technology devices and services

Cost Persons Served
1a. Total Cost from VII-2 funds 145,189
1b. Total Cost from other funds 192,459
2. Provision of assistive technology devices and aids 3
3. Provision of assistive technology services 1,664

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 1,256,633
1b. Total Cost from other funds 1,665,770
2. Orientation and Mobility training 1,786
3. Communication skills 2,266
4. Daily living skills 2,412
5. Supportive services (reader services, transportation, personal 13
6. Advocacy training and support networks 1,340
7. Counseling (peer, individual and group) 2,021
8. Information, referral and community integration 1,969
. Other IL services 2,503

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 91,786
1b. Total Cost from other funds 121,670
2. Information and Referral 1,029
3. Community Awareness: Events/Activities 719 45,635

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) 7,489,253 5,451,983 -2,037,270
2. Number of Individuals Served 3,487 3,112 -375
3. Number of Minority Individuals Served 785 722 -63
4. Number of Community Awareness Activities 1,746 719 -1,027
5. Number of Collaborating agencies and organizations 201 470 269
6. Number of Sub-grantees 17 18

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 1,664 100.00%
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) 630 37.86%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 885 53.19%
B1. Number of individuals who received orientation and mobility (O & M) services 1,786 100.00%
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) 904 50.62%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 959 53.70%
C1. Number of individuals who received communication skills training 2,266 100.00%
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) 1,289 56.88%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 1,263 55.74%
D1. Number of individuals who received daily living skills training 2,412 100.00%
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) 826 34.25%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 1,316 54.56%
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) 1,732 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) 13 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) 339 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 343 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) 30 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 Florida Division of Blind Services continues to function with the same business model as in the previous years. All OIB funds under the grant matched and supplemented with State General Revenue are contracted statewide to local Community Rehabilitation Programs/CRP’s (18) for the provision of adjustment to blindness services. The strategy continues to be the collaboration of the (10) existing Division Districts and the CRPs, targeting the unserved/unserved individuals identified in each district statewide.

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.

Contractors attempt to expand and improve services by incorporating new approaches to service delivery for the older blind population: • In October 2011, one agency began offering free weekly magnifying workshops to educate prospective clients about proper use of magnifiers and to help participants choose the most appropriate magnifier for their vision needs.

• Others offered “mini” ADL classes/in-service training, at independent living/ assisted living retirement communities and provided residents with on-site training to help them stay as independent as possible. In addition, the contractors offered caregiver training to the staff of these facilities.

Various community involvement activities were provided to participants. Below are examples:

• A deputy from the Sheriff’s Department presented a program on personal and home safety.

• A horticultural therapist provided a therapeutic container gardening workshop with emphasis on use of touch, taste, and smell.

• Low Vision Optometrists provided information on optical and non-optical devices as well as current information on medical management of various diseases of the eye.

• Ringling Museum of Art docents provided an accessibility tour of select paintings, providing vivid descriptions of the painting as well as background on the artist and the period. The tour was enhanced by use of visual and tactile media.

• The Art Center collaborated to provide special programs and tours of the art exhibits, including hands-on opportunities to experience art through touch and to create art.

• The Museum provided guided tours of permanent and special exhibits to class participants, with tactile, audio, and visual enhancements.

• Community Center for the Deaf and Hard-of-Hearing, dispenses amplified big button phones to clients with dual hearing/vision impairment, at no cost to clients.

• County Public Library systems collaborate to establish and maintain low vision resources in various county libraries. In addition, several libraries host low vision and health fairs annually at which Lighthouse participates.

• County Voter Services present information about and hands-on training with accessible voting machines. The Lighthouse provides sensitivity training to poll workers and prepares audio ballots upon request.

• Senior residential facilities partner with contractors to provide training on-site, to establish low vision support groups, and to present resources and information through health fairs and presentations.

• Several churches collaborated with contractors to provide satellite locations for training in outlying service areas.

• Local chapters of the Florida Council of the Blind and the Lions Club collaborate with contractors on special events and advocacy efforts, including White Cane Day.

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.

All contractors self-reported conducting their own Satisfaction Surveys and the feedback regarding services received by clients was found to be positive. Several contractors provided examples of their instrument with results.

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).

Below are typical descriptions of the impact of services from the contractors:

1.) A visually impaired woman has learned to travel independently using a white cane and is now travelling alone to visit her family. A blind man has learned how to cook for himself and is able to stay in his home rather than go to an assisted facility.

2.) An older client who was relying on her personal home aide to do everything for her is now able to do many things for herself. They were pouring her drinks and leaving them in the refrigerator, setting out her food, and she was staying inside her home. She is now pouring her own Pepsi (her favorite) and milk, heating her own food, and for the first time since her vision has gotten worse she has begun getting out to activities clubhouse again (which terrified her at first) and all of her neighborhood friends were thrilled to see her out. Her personal home aid commented that she is now willing to go with them to the store more and she is actively asking questions at her eye doctor appointments.

3.) Ms. X is just one of many who have been helped by the Lighthouse, but she has quite a compelling story with a very positive outcome. As with many of her counterparts, she suffered a major vision loss from glaucoma a number of years ago. Last March, she enrolled in the Lighthouse’s daily living skills classes in Winter Haven to learn techniques that would help restore her ability to live independently in her home and in community. She also learned mobility skills so she could travel about in the downtown area and in her neighborhood. In fact, it was during one of her outings that she made a significant discovery on her way to the local Library. She had just left the Lighthouse and was walking using her long white cane through downtown when she stumbled upon 4 Purls Yarn Shop, a small crafts store that specializes in all things knitting. She went in and began talking with the owner and some of the customers who were there. They told her about the knitting classes she could take to learn how to knit various items. Soon she was taking classes on the weekend and making items that anyone would have been proud to create such as beautiful scarves, knit caps, handbags, mittens, and many others. What was great was that the yarn shop employees had no qualms whatsoever about working with someone with a serious visual impairment. Later, she learned that the instructor had already worked with a totally blind patron and was able to teach this person some of the more advanced knitting techniques.

Ms. X shared her story with a United Way tour group that was visiting the Lighthouse a few months ago during the United Way campaign. She had several of her completed knitting projects with her at the time and showed them to the group. As expected, they were quite impressed with her work. The Lighthouse is always happy to observe the transformation of its graduates from helplessness to independence, especially when they become involved with pastimes that contribute to their health and well-being

4.) A pig farmer was getting lost in his front yard and on his farm while using his O&M cane incorrectly. He was taught the 2 pt. touch method. Now he can travel to the pig fence area to fix it and he has learned to travel on a dirt road to a friend’s house. He now uses his cane properly.

5.) A female minister lost her vision due to Diabetic Retinopathy. She was unable to prepare sermons for Sunday services. A functional vision assessment was conducted and a magnifier was given to her and she was able to read her Bible. She was also provided a CCTV to assist with reading material, equipment to cook and prepare meals, and white cane support which enabled her to travel to and from dialysis. An assistive Technology Instructor installed Magic Magnification on her computer and taught her how to use the program to enable her to continue to maintain records on the computer.

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

The main concern for this program is that the need for services is steadily increasing as the older population grows, and yet the funding for OIB services is decreasing.

There are transportation challenges in rural areas of counties. Transportation options can be limited, and cost usually is prohibitive for clients and expensive for agencies.

Our population continues to grow with a significant number who are of an enhanced age and frequently frail and/or medically involved. As previously stated, these clients now make up approximately 50% of the OIB participants, and require instruction in their home by our outreach specialists.

We are concerned about continued cuts to the budget and obtaining adequate funding to serve OIB clients.

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 byMondi Azpeitia
TitleProgram Consultant
Telephone850-245-0324
Date signed12/20/2012