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

RSA-7-OB for Alaska Dept of Labor and Workforce Development - Division of Vocational Rehab - H177B130002 report through September 30, 2013

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 year5,550
Title VII-Chapter 2 carryover from previous year2,814
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2225,000
A2. Total other federal39,813
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement5,550
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other34,263
A3. State (excluding in-kind)59,263
A4. Third party35,655
A5. In-kind1,837
A6. Total Matching Funds96,755
A7. Total All Funds Expended361,568
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs54,240
C. Total expenditures and encumbrances for direct program services307,328

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 0.1000 0.0000 0.1000
2. FTE Contractors 0.3219 3.5435 3.8654
3. Total FTE 0.4219 3.5435 3.9654

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 22 2.5758
2. Employees with Blindness Age 55 and Older 4 0.8547
3. Employees who are Racial/Ethnic Minorities 6 0.1858
4. Employees who are Women 25 3.6680
5. Employees Age 55 and Older 15 1.7815

C. Volunteers

135.00

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 FY187
2. Number of individuals who began receiving services in the reported FY157
3. Total individuals served during the reported fiscal year (A1 + A2) 344

B. Age

1. 55-5945
2. 60-6445
3. 65-6943
4. 70-7438
5. 75-7942
6. 80-8444
7. 85-8948
8. 90-9426
9. 95-9912
10. 100 & over1
11. Total (must agree with A3)344

C. Gender

1. Female230
2. Male114
3. Total (must agree with A3)344

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race3
2. American Indian or Alaska Native73
3. Asian8
4. Black or African American21
5. Native Hawaiian or Other Pacific Islander7
6. White225
7. Two or more races0
8. Race and ethnicity unknown (only if consumer refuses to identify)7
9. Total (must agree with A3)344

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)26
2. Legally Blind (excluding totally blind)101
3. Severe Visual Impairment217
4. Total (must agree with A3)344

F. Major Cause of Visual Impairment

1. Macular Degeneration120
2. Diabetic Retinopathy37
3. Glaucoma20
4. Cataracts39
5. Other128
6. Total (must agree with A3)344

G. Other Age-Related Impairments

1. Hearing Impairment55
2. Diabetes36
3. Cardiovascular Disease and Strokes78
4. Cancer13
5. Bone, Muscle, Skin, Joint, and Movement Disorders54
6. Alzheimer's Disease/Cognitive Impairment22
7. Depression/Mood Disorder21
8. Other Major Geriatric Concerns101

H. Type of Residence

1. Private residence (house or apartment)317
2. Senior Living/Retirement Community13
3. Assisted Living Facility11
4. Nursing Home/Long-term Care facility3
5. Homeless0
6. Total (must agree with A3)344

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)64
2. Physician/medical provider39
3. State VR agency11
4. Government or Social Service Agency31
5. Veterans Administration3
6. Senior Center6
7. Assisted Living Facility15
8. Nursing Home/Long-term Care facility5
9. Faith-based organization1
10. Independent Living center22
11. Family member or friend59
12. Self-referral68
13. Other20
14. Total (must agree with A3)344

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 29,217
1b. Total Cost from other funds 16,240
2. Vision screening / vision examination / low vision evaluation 160
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 59,496
1b. Total Cost from other funds 12,593
2. Provision of assistive technology devices and aids 257
3. Provision of assistive technology services 240

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 92,410
1b. Total Cost from other funds 16,616
2. Orientation and Mobility training 42
3. Communication skills 185
4. Daily living skills 247
5. Supportive services (reader services, transportation, personal 144
6. Advocacy training and support networks 119
7. Counseling (peer, individual and group) 78
8. Information, referral and community integration 156
. Other IL services 101

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 32,547
1b. Total Cost from other funds 17,507
2. Information and Referral 340
3. Community Awareness: Events/Activities 158 2,727

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) 303,164 361,568 58,404
2. Number of Individuals Served 369 344 -25
3. Number of Minority Individuals Served 131 109 -22
4. Number of Community Awareness Activities 190 158 -32
5. Number of Collaborating agencies and organizations 86 64 -22
6. Number of Sub-grantees 4 4

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 240 100.00%
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) 94 39.17%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 75 31.25%
B1. Number of individuals who received orientation and mobility (O & M) services 42 100.00%
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) 41 97.62%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 18 42.86%
C1. Number of individuals who received communication skills training 185 100.00%
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) 79 42.70%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 17 9.19%
D1. Number of individuals who received daily living skills training 247 100.00%
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) 85 34.41%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 24 9.72%
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) 99 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) 11 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) 2 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 9 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) 4 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 Alaska Division of Vocational Rehabilitation sub-grants OB funds to four agencies located in the four main regions of the state. Since Alaska is such a large state, subgranting the funds throughout the state makes it possible to serve many individuals in their remote home communities. Services are also provided in-house at the agencies,and occasionally individuals need to travel to participate. Three of the four sub-grantees are independent living centers that provide the full array of IL services that benefit many of the OB consumers. The four sub-grantees are:

1. Alaska Center for the Blind and Visually Impaired 2. Access Alaska Independent Living Center, Fairbanks 3. Kenai Peninsula Independnet Living Center 4. Southeast Alaska Independent Living, (SAIL)

Following is an example how outreach is conducted in Alaska: Staff work closely with other agencies providing services in Fairbanks and rural service areas to coordinate outreach activities and service delivery in the interior region.

Partnerships with Tanana Chiefs, Fairbanks Native Association Senior Program, Nenana Senior Center and Tok Senior Center have resulted in a coordinated and comprehensive approach to service delivery in both Fairbanks and rural communities.

OB staff participate in outreach activities to agencies serving populations that have traditionally been underserved. Outreach activities were conducted at local senior housing complexes, Fairbanks Rescue Mission, Fairbanks Vet Center, and the Division of Vocational Rehabilitation in order to reach the unserved and underserved population.

OB staff participated in coordinated activities with other service providers through staffing booths at community activities to include the Veterans-Stand-Down and Tanana Valley State Fair. OB staff participates in rural community health and wellness activities. This year staff participated in health fairs in the rural communities of Healy and Denali Park.

One subgrantee conducts outreach through direct travel to remote communities, quarterly newsletters and website, and through telephonic communication. Each fiscal year, subgrantees strive to travel to remote villages and do outreach, often in close conjunction with senior and healthcare providers. Through networking with partners and an effort to have outreach activities at easily accessible locations known by seniors, subgrantees aim to increase exposure in rural communities as well as connect individuals who are unserved or underserved to other services including Older Blind services.

PSAs and service provider contacts are initiated on a quarterly basis in other outreach areas including Valdez, Kodiak and Copper Center. Individual services continue to be provided through collaboration with Cordova Family Resource Center, Native Village of Eyak and the Valdez Long Term Care.

Agencies often share responsibility for maintaining contact with clients and providers when traveling in rural areas to conduct agency business. Contacts for the Older Blind Program included visits to the agencies serving seniors, such as health clinics, Tribal Vocational Rehabilitation offices, senior centers, Native health corporations, and hospitals as well as local Lions Clubs. During those visits, information about the services provided by and ways to refer to the Older Blind Program was distributed.

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.

All subgrantees participate in a variety activities designed to expand or improve services through collaborative activities and community awareness. Contracts have been developed with Assistive Technology of Alaska (ATLA) for training and setting up AT demonstration sites throughout the state. Many of the grantees also partner with the Alaska Center for the Blind and Visually Impaired (ACBVI) for specialized services. This past year several individuals received for low vision assessments conducted by the Center in various locations throughout the state.

Public awareness about the OB program continues to grow due to community outreach and word of mouth. Public Service Announcements were aired quarterly, brochures were distributed to eye doctors, and community monthly service provider meetings were attended and staff participated at local health fairs to increase public awareness. Relevant low vision trainings were attended by OB staff. Demonstrations occured throughout the fiscal year showing low vision assistive technology at health fairs and other community events. Health fairs offered an excellent opportunity to introduce a large number of community members to low vision information, resources and AT.

One subgrantee that is a Center for Independent Living, SAIL, started a new program Home Modifications for Aging in Place (HomeMAP) which assisted numerous severely low vision consumers to remain in their homes.

Half of the OB subgrantees are also memebers of Alaska’s SILC.

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.

Feedback about the OB program has been very positive. Multiple tools were utilized to obtain ongoing consumer feedback, including online/website feedback; designated time during peer support groups and board meetings provided an excellent format to gain feedback; consumer satisfaction surveys were also developed and utilized. Surveys report that the OB program provides valuable resources and opportunities for individuals to try out assistive technology. Below are some comments from OB cosumers: It was helpful, especially knowing about a CCTV which can be borrowed from the Center. Appreciated the information and the devices. The information was good and the staff very professional. Looking forward to receiving the magnifier. Thanks. I’m looking forward to coming back. The Center is just great. Everyone there is wonderful. I appreciate being able to come there — I’ve learned so much.

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).

BG and Margo are regular attendees of the Low Vision Support Group. B.G is a 73 year old woman with severe vision and hearing loss. B.G and her service dog, Margo, live in Ketchikan. B.G says, “the support group is beneficial because I hear and learn from others with similar challenges, including dealing with grieving and loss. And being with my peers helps me not feel so alone”.

This subgrantee helped B.G. obtain a portable digital magnifier and voice recognition software. Now BG can communicate with her family and keep up with current events. Thanks to the subgrantee support, B.G. says she feels less isolated and more connected to her community.

A woman in her early 60’s who is completely blind came in for instruction on a newer version of Windows (10) so she could remain competitive at work. She was given several individualized sessions at the Center and in her home. She said the instruction helped her immensely to feel confident in her ability to remain on the job - one she has held for many years - despite reductions and cutbacks that were occurring. Another woman who is always well-dressed and has had Macular Degeneration for many years came for a low vision clinic and selected devices that she very much needed to remain as independent as possible (the devices were purchased using other funds). "I love the measuring cups. The large letters make them so easy to see. It’s nice to be able to use them in my kitchen. the lamp also works very well and helps when I am reading. I am very happy with my devices. Thank you." E.

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

Alaska’s challenges with the OB program have remained relatively unchanged over the years. The combination of travel combined with contracted services can become very quickly expensive and therefore somewhat prohibitive, but the state and OB subgrantees strive to serve as many people as possible in Alaska’s large geographical area within budget constraints.

Physical Distance: This continues to be a challenge in light of declining funds and increasing costs for air AND ground travel in Southcentral Alaska. Although emails are sent to specific contacts in outlying areas, they are not a productive replacement for the vital face-to-face community visits. Many of the subgrantees have maximized the productivity of staff travel as much as possible.

Financial/Staff Limitations: Travel outside of Anchorage is primarily by airplane, and is costly and often limited by weather conditions and/or seasonal subsistence activities. Even the areas accessible by road, such as Copper Center, are several hours away necessitating an overnight stay and considerable fuel expense. Further, the need for services is far greater than can begin to be met with current resources.

Another significant problem/concern is the lack and limitation of local transportation in rural areas. Bus routes do not serve a majority of the residential sections on the out-skirts of communities, and none in rural areas. Local transportation limitations significantly impact client’ s ability to access services and resources.

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 byVelja Elstad
TitleIL OIB Program Coordinator
Telephone907 465-6932
Date signed12/20/2013