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

RSA-7-OB for Louisiana Rehabilitation Services - H177B120018 report through September 30, 2012

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year448,435
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 2448,435
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-kind49,826
A6. Total Matching Funds49,826
A7. Total All Funds Expended498,261
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs0
C. Total expenditures and encumbrances for direct program services498,261

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 0.3800 0.0000 0.3800
2. FTE Contractors 2.2000 10.0100 12.2100
3. Total FTE 2.5800 10.0100 12.5900

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 9 4.0100
2. Employees with Blindness Age 55 and Older 1 0.0200
3. Employees who are Racial/Ethnic Minorities 7 3.7200
4. Employees who are Women 20 9.8300
5. Employees Age 55 and Older 6 0.4900

C. Volunteers


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 FY659
2. Number of individuals who began receiving services in the reported FY633
3. Total individuals served during the reported fiscal year (A1 + A2) 1,292

B. Age

1. 55-59119
2. 60-64116
3. 65-69130
4. 70-74139
5. 75-79194
6. 80-84222
7. 85-89229
8. 90-94107
9. 95-9932
10. 100 & over4
11. Total (must agree with A3)1,292

C. Gender

1. Female831
2. Male461
3. Total (must agree with A3)1,292

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race11
2. American Indian or Alaska Native5
3. Asian5
4. Black or African American288
5. Native Hawaiian or Other Pacific Islander1
6. White885
7. Two or more races7
8. Race and ethnicity unknown (only if consumer refuses to identify)90
9. Total (must agree with A3)1,292

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)97
2. Legally Blind (excluding totally blind)913
3. Severe Visual Impairment282
4. Total (must agree with A3)1,292

F. Major Cause of Visual Impairment

1. Macular Degeneration678
2. Diabetic Retinopathy172
3. Glaucoma183
4. Cataracts44
5. Other215
6. Total (must agree with A3)1,292

G. Other Age-Related Impairments

1. Hearing Impairment353
2. Diabetes295
3. Cardiovascular Disease and Strokes237
4. Cancer122
5. Bone, Muscle, Skin, Joint, and Movement Disorders195
6. Alzheimer's Disease/Cognitive Impairment79
7. Depression/Mood Disorder43
8. Other Major Geriatric Concerns174

H. Type of Residence

1. Private residence (house or apartment)1,060
2. Senior Living/Retirement Community110
3. Assisted Living Facility70
4. Nursing Home/Long-term Care facility52
5. Homeless0
6. Total (must agree with A3)1,292

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)526
2. Physician/medical provider80
3. State VR agency18
4. Government or Social Service Agency25
5. Veterans Administration62
6. Senior Center20
7. Assisted Living Facility29
8. Nursing Home/Long-term Care facility3
9. Faith-based organization6
10. Independent Living center4
11. Family member or friend250
12. Self-referral222
13. Other47
14. Total (must agree with A3)1,292

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 1,043,850
1b. Total Cost from other funds 4,950
2. Vision screening / vision examination / low vision evaluation 738
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 150,281
1b. Total Cost from other funds 63,217
2. Provision of assistive technology devices and aids 1,180
3. Provision of assistive technology services 770

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 161,345
1b. Total Cost from other funds 3,500
2. Orientation and Mobility training 313
3. Communication skills 937
4. Daily living skills 632
5. Supportive services (reader services, transportation, personal 223
6. Advocacy training and support networks 314
7. Counseling (peer, individual and group) 295
8. Information, referral and community integration 698
. Other IL services 1

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 1,172
1b. Total Cost from other funds 2,800
2. Information and Referral 1,301
3. Community Awareness: Events/Activities 141 8,288

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) 375,733 233,734 -141,999
2. Number of Individuals Served 1,694 1,292 -402
3. Number of Minority Individuals Served 517 407 -110
4. Number of Community Awareness Activities 147 45 -102
5. Number of Collaborating agencies and organizations 49 49 0
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 770 100.00%
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) 1,221 158.57%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 228 29.61%
B1. Number of individuals who received orientation and mobility (O & M) services 313 100.00%
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) 313 100.00%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 147 46.96%
C1. Number of individuals who received communication skills training 937 100.00%
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) 937 100.00%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 158 16.86%
D1. Number of individuals who received daily living skills training 632 100.00%
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) 632 100.00%
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) 7,930 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) 25 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 54 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) 42 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 continues functioning 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. It also serves as a mobile classroom for consumers of independent living older blind services.

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 which are geared toward expansion or improvement of their programs/services: ? Continued work with VA to accept and to make referrals of consumers as appropriate. ? Collaboration with several universities to accept interns in low vision and/or human service related fields. ? 16 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 at councils on aging, health fairs, etc. ? Participation in local observations of events such as National White Cane Day and “Meet the Blind month.” ? Provision of sensitivity training opportunities to staff members of local law enforcement agencies. ? 7 plus presentations to school aged children on blindness. ? 8 plus newspaper articles featuring older blind services and/or individuals ? Radio and TV commercials/appearances ? Each contractor has established relationships with various assisted living facilities and churches in their respective geographic service region to host their staff while providing services to consumers of older blind services. ? All contractors have developed and/or maintain 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 consumer served was given the opportunity to complete a survey regarding their satisfaction with services. This year, we had a total of 231 respondents, with consumers indicating the highest degree of satisfaction with services approximately 99% of the time. Each contractor performs their own consumer satisfaction survey. In addition to this, program staff with the state agency conduct follow-up calls with randomly selected consumers, and monitor the contract, including review of consumer files, with each contractor.

In general, negative comments included in survey responses are based on the consumer’s disappointment with the provided technology not meeting their expectations. Such complaints include being disappointed with the field of view when using a magnifier or provision of a magnifier would not be beneficial

The following are a few comments taken directly from consumer surveys: ? Items they provided helped me to see better at home. ? The staff was very helpful ? All of the little assistive devices make life a lot easier. ? Services rock! They should be worldwide. ? She arrived on time and greeted me with a smile. She answered every question and explained every device. ? She included my family in the meeting.

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).

Mr. X is a retired veteran in his 80’s and has received services over the past several years. He has attended retreats, as well as received in home services. He has mastered Grade 2 Braille and has recently been hired as a Braille teacher in a local school system. He loves working with the children, and is very excited about the extra income he will be receiving, which will help send his grandson to college. He indicated that working makes him “feel useful again.”

Services were provided to a retired truck driver in his mid 60’s who was extremely depressed prior to receiving services. He stated he had given up doing anything around the house, and felt like his “life was over.” He received training in his home, then attended a retreat, and learned the skills needed to regain his confidence. While at the retreat, he expressed a strong interest in training in the kitchen, which was an area in which he previously had very limited exposure. During the retreat, he learned to independently prepare an entire meal for the group, and discovered that he loves to cook. He also underwent orientation and mobility training and began using his cane to get out and go to the store and church. He recently unexpectedly called to let us know that he got a part time job in the food service industry, and stated he would never have had the confidence to apply if it wasn’t for the services he received.

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. Additionally, our contractors are reporting that many people who live in rural areas do not regularly access healthcare. This has enabled our contractor in the most rural areas of the state to partner with rural healthcare providers so they can refer among each other as required to meet the consumer’s needs.

This year, one of our contractors experienced difficulty in achieving some of their contract goals. This is attributed to staff turnover, and is not anticipated to affect future performance.

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
Date signed12/21/2012