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

RSA-7-OB for Michigan Commission for the Blind - H177B120022 report through September 30, 2012

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year1,071,864
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year0
Other federal grant carryover from previous year165,595
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 21,008,384
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)119,094
A4. Third party0
A5. In-kind0
A6. Total Matching Funds119,094
A7. Total All Funds Expended1,127,478
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs93,044
C. Total expenditures and encumbrances for direct program services1,034,434

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 0.8000 5.3700 6.1700
2. FTE Contractors 1.0000 5.0700 6.0700
3. Total FTE 1.8000 10.4400 12.2400

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 8 1.8600
2. Employees with Blindness Age 55 and Older 6 2.9700
3. Employees who are Racial/Ethnic Minorities 16 3.4700
4. Employees who are Women 55 9.7200
5. Employees Age 55 and Older 18 0.7300

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 FY720
2. Number of individuals who began receiving services in the reported FY302
3. Total individuals served during the reported fiscal year (A1 + A2) 1,022

B. Age

1. 55-5986
2. 60-6498
3. 65-69107
4. 70-74103
5. 75-79140
6. 80-84169
7. 85-89189
8. 90-9495
9. 95-9932
10. 100 & over3
11. Total (must agree with A3)1,022

C. Gender

1. Female725
2. Male297
3. Total (must agree with A3)1,022

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race13
2. American Indian or Alaska Native4
3. Asian2
4. Black or African American153
5. Native Hawaiian or Other Pacific Islander0
6. White778
7. Two or more races72
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)1,022

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)62
2. Legally Blind (excluding totally blind)931
3. Severe Visual Impairment29
4. Total (must agree with A3)1,022

F. Major Cause of Visual Impairment

1. Macular Degeneration452
2. Diabetic Retinopathy131
3. Glaucoma133
4. Cataracts12
5. Other294
6. Total (must agree with A3)1,022

G. Other Age-Related Impairments

1. Hearing Impairment116
2. Diabetes107
3. Cardiovascular Disease and Strokes166
4. Cancer35
5. Bone, Muscle, Skin, Joint, and Movement Disorders206
6. Alzheimer's Disease/Cognitive Impairment16
7. Depression/Mood Disorder49
8. Other Major Geriatric Concerns168

H. Type of Residence

1. Private residence (house or apartment)817
2. Senior Living/Retirement Community143
3. Assisted Living Facility27
4. Nursing Home/Long-term Care facility35
5. Homeless0
6. Total (must agree with A3)1,022

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)169
2. Physician/medical provider82
3. State VR agency10
4. Government or Social Service Agency34
5. Veterans Administration14
6. Senior Center38
7. Assisted Living Facility2
8. Nursing Home/Long-term Care facility2
9. Faith-based organization2
10. Independent Living center13
11. Family member or friend213
12. Self-referral411
13. Other32
14. Total (must agree with A3)1,022

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 4,940
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 110
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 226,890
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 354
3. Provision of assistive technology services 71

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 29,909
1b. Total Cost from other funds 0
2. Orientation and Mobility training 683
3. Communication skills 121
4. Daily living skills 151
5. Supportive services (reader services, transportation, personal 14
6. Advocacy training and support networks 30
7. Counseling (peer, individual and group) 92
8. Information, referral and community integration 78
. Other IL services 100

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 80
3. Community Awareness: Events/Activities 77 253

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) 1,461,641 1,127,478 -334,163
2. Number of Individuals Served 1,001 1,022 21
3. Number of Minority Individuals Served 197 244 47
4. Number of Community Awareness Activities 14 5 -9
5. Number of Collaborating agencies and organizations 12 0 -12
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 71 100.00%
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) 13 18.31%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 53 74.65%
B1. Number of individuals who received orientation and mobility (O & M) services 683 100.00%
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) 14 2.05%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 596 87.26%
C1. Number of individuals who received communication skills training 121 100.00%
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) 25 20.66%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 86 71.07%
D1. Number of individuals who received daily living skills training 151 100.00%
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) 26 17.22%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 106 70.20%
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) 105 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) 9 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) 0 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) 5 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.

Pursuant to the Governor’s Executive Order 2012-10 effective October 1, 2012, the agency’s new name is the Bureau of Services for Blind Persons, formerly known as the Michigan Commission for the Blind.

Over the past year, the Bureau of Services for Blind Persons (BSBP) agency continues to expand and increase ways to provide services to unserved and underserved populations. The agency focused on working with local area agencies on aging (Region 1b, Region 2 and Valley Area on Aging) to identify areas of need within the local community, securing interpreters and translators as needed for ESL consumers. As the population increases with multiple languages, these efforts are needed to order to meet the increasing demands for services to individuals with English as a second language. The agency continues to diversify its network and outreach with other professional and community partners, which includes senior centers, adult foster care, Commission on Aging, and eye care professionals to ensure that services are explained and materials are provided in order that consumers may contact the agency. Additionally, the BSBP collaborated with a private mobility contractor, local division on aging and Lions Club to provide various services to consumers to assist in leader dog care by providing transportation for individuals to and from Leader Dogs. Through this coordination, individuals are gaining independence and confidence in maintaining their lives within their home and communities.

The agency contracts with SVRC, Inc to provide independent living 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.

BSBP staff are creative in their approaches to expand and enhance service delivery for individuals with blindness and visually impaired. Through the collaboration with the various community agencies and organizations, the agency was able to increase services to a host of individuals. The following activities are some examples of BSBP’s efforts to expand and increase, as well as to inform individuals about the services and service provision: Intensive community outreach consists of meeting with various organizations that work with the aging population such as professional offices, libraries, senior centers, senior meal sites and churches to provide information and answer questions about the program and services offed by the agency. Educational presentations are coordinated to increase awareness of BSBP and to foster positive attitudes about blindness and low vision thus minimizing fears related to blindness and independence. Mini Adjustment programs around the state of Michigan serves as a mobile classroom and enables the agency to provide training in skills of blindness to newly older blind individuals. These activities are designed to increase outreach and positively impact more consumers. Presentations were presented at a variety of public forums that included health fairs, senior housing facilities and professional groups, as well as support groups. Individuals who attended shared information about services provided to others and the agency received numerous inquiries. In one area of the state, a staff member developed a project where CCTV’s were donated from families of former consumers to current consumers that could utilize them in their daily living activities. The family members believed by donating the CCTV’s, that the memory of their loved ones could continue to positively affect the lives of others. The equipment promoted greater independence for these individuals in caring out their daily living activities.

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.

BSBP in collaboration with Michigan State University and Michigan Rehabilitation Services jointly conducted a Comprehensive Needs Assessment for the each agency’s programs. The Needs Assessment indicated that BSBP should increase efforts in outreach to persons with blindness and low vision. As stated in this report, BSBP has increased activities focusing on unserved areas in the state to eliminate the lack of services. The Comprehensive Needs Assessment further stated that BSBP should work more with ophthalmologists and optometrists to provide pamphlets and brochures on the agency services. Each year the agency participates in the Michigan Optometric Association Conference where optometrists and student optometrists are present. This event provides an opportunity for BSBP to display material regarding services, as well as an opportunity for attendees to inquire about services and assistance that the agency provides.

From the Comprehensive Needs Assessment FY 2011 Underserved Populations

MCB staff comments echoed those of the other two agencies but the MCB staff identified older blind and low vision Michigan residents as the primary underserved population SUMMARY OF FINDINGS In addition, MCB and CIL staff identified older blind and low vision Michigan residents and Somalian and Native American residents with disabilities as populations they believe are underserved by their agency Age Related Underserved Population Older Michigan Residents who are Blind or have Low Vision and VR Services There has been a slow but notable decrease in the proportion of older customers receiving vocational rehabilitation services from MCB during the past three years (5.3% in 2009; 6.0% in 2008; 11.3% in 2007). The need for improved services for this population was also identified in the Key Informant and staff survey qualitative data. These combined findings suggest that older blind and low vision customers are an underserved population at MCB. Recommendation: MCB need to increase outreach efforts to older Michigan residents who are blind or have low vision. These efforts could include providing medical doctors, ophthalmologists who specialize in low vision and gerontologists with information and brochures.

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).

“No thank you, I’m doing pretty well on my own” is a common statement that a vision rehabilitation therapist from the Bureau of Services for Blind Persons often hears. This consumer was no different; however, after speaking with her family and scheduling a visit with the vision rehabilitation therapist, the consumer changed her mind and began her journey to independence.

As the center point for her family, the consumer manages a lot of responsibilities and needed techniques to continue to function independently in almost every aspect of her life. Although the consumer had a high number of IL goals, her warm personality and easy going spirit helped guide her through rehabilitation services seamlessly. Specifically, she has been able to continue to travel independently with the help of the white cane and sun shades, manage her finances and appointments with a large print calendar, check writing guides and 20/20 pens. The consumer is also able to safely prepare her families favorite dishes through the use of various assistive devices. I observed her confidence and skill levels increase as she will now proudly use her white cane and travel across the street to the local store, a task that once seemed daunting to her.

I believe that this consumer’s involvement with the Bureau of Services for Blind Persons taught her skills that she may never have learned otherwise and promoted her independence. Aside from providing skills and training, I believe that fostering a welcoming and safe environment for her played a major role in her success.

In the customer service world, the sincerest form of flattery is a referral from a satisfied customer, and this consumer has done just that. The consumer commented about the wonderful services she received within her living community and shared information about the Bureau of Services for Blind Persons prompting two new referrals to the Independent Living Program.

Ms. M K is 72 years old and a grandmother of 6. When she began services with the Michigan Commission for the Blind (now the Michigan Bureau of Services for Blind Persons BSBP), her vision had declined just to the point of being legally blind. She was devastated and had no idea what she was going to do. She contacted the BSBP, and a vision rehabilitation therapist (VRT) went to see her because, at that time, she was considered for the Independent Living Program ILP. However, during the first interview, she casually mentioned that she had a work telephone number. The VRT immediately began getting her involved with the Vocational Rehabilitation program. Ms. K admitted during this first interview that she thought she would have to quit her job because her vision impairment was making it too hard to read the documents necessary for her to perform her duties as the building manager of the senior apartment building where she was also a resident.

Throughout the first year working with her, Ms. K did not partake of the available VR services because she still couldn’t imagine how she would be able to perform the necessary reading for her job. She attended a 5-day mini adjustment program in her area, and then she went to the BSBP Training Center located in Kalamazoo where she also mentioned she had been working, but now she had a deadline of October 1st to decide whether she would return to her job. It was discovered that her supervisor had been discussing with her during the year how they could accommodate her so that she could return to her job. They were willing to work with her regarding workplace accommodations. The VR counselor at the Training Center phoned VRT about the client’s interest, and we finally got Ms. K to accept services from the VR program.

Ms. K received services from both the IL and VR programs in her quest to be independent and employed. She has reported being very happy to be back working, feeling very satisfied with being able to remain in the workforce, and her supervisor is still very pleased with her work. Ms. K is a shining star to the IL and to the VR programs that provided services. She continues to talk with others about the programs and has made several referrals of seniors with whom she is acquainted in the building she manages. The last time VRT spoke in person with Ms. K, she was grinning from ear to ear despite the fact that her vision had continued to decline over the past couple of years.

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

The agency is working diligently to provide training for staff on the client tracking system to improve data collection.

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 byLeamon Jones
TitleConsumer Services Director
Telephone517 373-0579
Date signed12/27/2012