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

RSA-7-OB for Rehabilitation Services Administration, DC Dept. on Disability Services - H177B130051 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 year0
Title VII-Chapter 2 carryover from previous year218,535
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2242,154
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)25,000
A4. Third party0
A5. In-kind0
A6. Total Matching Funds25,000
A7. Total All Funds Expended267,154
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs21,350
C. Total expenditures and encumbrances for direct program services245,804

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 0.1976 0.7471 0.9447
2. FTE Contractors 0.0000 2.0000 2.0000
3. Total FTE 0.1976 2.7471 2.9447

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 5 0.6534
2. Employees with Blindness Age 55 and Older 1 0.1274
3. Employees who are Racial/Ethnic Minorities 6 0.8798
4. Employees who are Women 4 0.6164
5. Employees Age 55 and Older 1 0.0005

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 FY21
2. Number of individuals who began receiving services in the reported FY29
3. Total individuals served during the reported fiscal year (A1 + A2) 50

B. Age

1. 55-596
2. 60-6415
3. 65-695
4. 70-749
5. 75-794
6. 80-844
7. 85-893
8. 90-943
9. 95-991
10. 100 & over0
11. Total (must agree with A3)50

C. Gender

1. Female34
2. Male16
3. Total (must agree with A3)50

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race3
2. American Indian or Alaska Native0
3. Asian0
4. Black or African American44
5. Native Hawaiian or Other Pacific Islander0
6. White3
7. Two or more races0
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)50

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)21
2. Legally Blind (excluding totally blind)27
3. Severe Visual Impairment2
4. Total (must agree with A3)50

F. Major Cause of Visual Impairment

1. Macular Degeneration1
2. Diabetic Retinopathy12
3. Glaucoma15
4. Cataracts22
5. Other0
6. Total (must agree with A3)50

G. Other Age-Related Impairments

1. Hearing Impairment5
2. Diabetes20
3. Cardiovascular Disease and Strokes4
4. Cancer5
5. Bone, Muscle, Skin, Joint, and Movement Disorders23
6. Alzheimer's Disease/Cognitive Impairment5
7. Depression/Mood Disorder4
8. Other Major Geriatric Concerns36

H. Type of Residence

1. Private residence (house or apartment)48
2. Senior Living/Retirement Community0
3. Assisted Living Facility0
4. Nursing Home/Long-term Care facility2
5. Homeless0
6. Total (must agree with A3)50

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)0
2. Physician/medical provider0
3. State VR agency0
4. Government or Social Service Agency2
5. Veterans Administration0
6. Senior Center0
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization0
10. Independent Living center0
11. Family member or friend3
12. Self-referral45
13. Other0
14. Total (must agree with A3)50

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 8,261
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 50
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 99,815
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 50
3. Provision of assistive technology services 50

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 67,963
1b. Total Cost from other funds 0
2. Orientation and Mobility training 15
3. Communication skills 3
4. Daily living skills 18
5. Supportive services (reader services, transportation, personal 5
6. Advocacy training and support networks 20
7. Counseling (peer, individual and group) 3
8. Information, referral and community integration 43
. Other IL services 5

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 0
3. Community Awareness: Events/Activities 2 45

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) 209,304 267,154 57,850
2. Number of Individuals Served 133 50 -83
3. Number of Minority Individuals Served 119 0 -119
4. Number of Community Awareness Activities 30 4 -26
5. Number of Collaborating agencies and organizations 20 9 -11
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 50 100.00%
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) 14 28.00%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 4 8.00%
B1. Number of individuals who received orientation and mobility (O & M) services 15 100.00%
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) 0 0.00%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 15 100.00%
C1. Number of individuals who received communication skills training 3 100.00%
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) 5 166.67%
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 18 100.00%
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) 3 16.67%
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) 0 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) 18 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) 3 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) 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.

In FY 2013 the agency took steps to diversify the service providers affiliated with the program through the development of an Independent Living Services Human Care Agreement. This IL Human Care Agreement will enable the agency to select from a catalog of IL services that will include specialized services and certified specialist in the field of blind rehabilitation, Orientation and Mobility, adaptive technology, and Vision Therapy A VR counselor has now been assigned to the visual impairment unit to focus on coordinating all IL services, including the IL Older Blind program. This addition to the visual impairment unit will enhance the agency’s capacity to better serve IL OB consumers with multiple disabilities, including those who are deaf blind. The primary HCA providers are Columbia Lighthouse for the Blind, the DC CIL, and the Metropolitan Washington EAR. Outreach activities are constant and a very important activity for the population served. The DCCIL, Inc. Columbia Lighthouse for the Blind and RSA’s Visual Impairment Unit work within the community to reach the underserved and/or unserved populations by reaching out to such community resources as the church, community leaders, local doctor’s offices, and hospitals. In addition to the above mentioned activities, RSA is in collaboration with the Martin Luther King Jr. Library and the National Federation of the Blind to utilize its News Line to reach the rich and diverse population residing in the Washington, DC metropolitan area

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.

Expanded IL Services to Older Blind, Deaf and Deaf Blind

DDS/RSA and the DC Office on Aging worked together to expand services available to older persons who are blind, deaf or deaf/blind. Services were expanded in a number of senior centers through and MOU between DD/RSA and DCOA. Through the MOU, DDS/RSA provided funds to DCOA to provide the following services:

The Ward 8 Lead Agency — Deaf and Hard of Hearing Senior Center This program provided services to over twenty participants weekly which also included seniors who were deaf/blind. Services included nutritious meals, transportation to sites and activities, health promotion, recreation socialization activities which includes trips and individual and group counseling, teaching American Sign Language to the hearing seniors and to the late deaf who have never learned to communicate through sign; and self-advocacy training for the deaf and hard of hearing to ensure they are obtaining equipment, services, and benefits necessary to their activities of daily living. This training includes assisting participants with contacting the fire department so they can receive appropriate detectors, such as the flashing fire detector and lighted telephone. Additionally, participants may receive training on the TTY systems and deaf relay systems, which allow them to communicate with the outside world. New technology such as the VP Sorenson Video phone allow consumers that no longer use the TTY system to see and communicate with the person that they are talking with through using manual sign language

The Ward 5 Lead Agency Center for the Blind provided a nutritious lunch, independent living skills training, Braille and other communication skills training, music therapy, arts and crafts, recreational trips, counseling, case management and transportation to and from the Ward 5 Lead Agency center, five days per week for at least twenty older blind and visually impaired consumers each month.

The Ward 5 Model Cities Senior Wellness Center provided program space two days per week to provide a nutritious lunch, independent living skills training, Braille and other communication skills training, music therapy, arts & crafts, recreational trips, counseling, case management, and transportation to and from the facility to up to ten older blind consumers monthly. Expanded assistive technology training for older blind seniors was initiated during the end of FY 13 in partnership with the DC CIL in the Center’s satellite location with the Greater Washington Urban League for two half days per week. Full classes will begin in October FY 14

Expanded Low Vision Services to 30 Public and Private Senior Centers In an effort to enhance the aging community’s access to low vision devices and to demonstrate how these special devices may increase personal independence in daily living, 30 portable CCTVs were purchased for senior centers that will potentially be utilized by over 100 District blind, visually impaired and deaf blind seniors annually. The Liberty Scholar 2 is a portable, lightweight, video magnifier with both near and distance viewing capabilities, enabling users to read, write, and view distance objects. With its compact design and features, such as a 10x optical zoom range, full suite of color modes, and rechargeable batteries that may be used for recreational and literacy support.

Free Eye Screenings Sponsored by DDS RSA in partnership with the Columbia Lighthouse for the Blind for 3 DC Office on Aging Senior Wellness Centers

Ward 1 — Bernice Fonteneau Senior Wellness Center 24 patients screened Ward 8 — Congress Heights Senior Wellness Center — 25 patients screened Ward 4 — Hattie Holmes Senior Wellness Center 15 patients screened

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.

Satisfaction surveys and community feedback sessions were not conducted specific to ILOB services to consumers due to the delayed finalization of the MOU between DDS and DC Office on Aging.

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).

Ms. K is a 65 year old widowed female who lives alone and has low vision due to macular degeneration. Her vision had been slowly decreasing since 2007 which was also around the time her husband died. Ms. K had a time adjusting to her loses and basically shut herself off from people and activities. She was having difficulty with tasks like identifying colors, reading materials like mail and the labels on her prescription bottles, paying bills, traveling safely in the community, cooking safely, etc. Ms. K stated that she was a very private person and found it hard at times to open up and ask others for help; especially since the people she had to deal with lacked understanding of what she was experiencing as a person with a visual impairment; however she decided to pull herself together and seek assistance in order to be able to function more self sufficiently and contacted a number of community agencies for services and support, one of which was the DCRSA Independent Living Unit Older Blind Section. By the time Ms. K saw this IL Counselor, she had already received IL and O and M training, a Sarah Scanner and was involved in Peer Support in the community. Ms. K needed additional Orientation and Mobility Training, a Low Vision Evaluation and magnifiers, Information and Referral Services, AT Assessment and various Assistive Devices to increase her ability to perform certain tasks. She was coming out of her shell but needed more support and encouragement from the IL Counselor to reach her full potential.

With the provision of an AT Assessment and keyboarding training, Low Vision Evaluation, magnifiers to increase her ability to see and to read, O and M training to increase her ability to travel safely and with more confidence, Information and Referral Services to community resources and Assistive devices (a Pen Friend, Talking Bible, Bump Dots, talking Compus, etc) which improved her ability to read her medication and other materials, coordinate and organize her appointments and other important imformation, cook safely and operate the microwave/stove/laundry machines more efficiently, etc; the client became more motivated and began to get out more in the community. Ms. K informed the IL Counselor that she was very pleased with the devices and services she had received and was not only involved with peer support, but joined a senior group once a month and had just come back from a cruise, is involved in more church activities and can now read her Bible, attends the MLK Library’s keyboarding and computer training and loves it, is now running peer support groups as a Peer Coordinator at the Columbia Lighthouse for the Blind and is doing so much more. She encourages others who are experiencing similar adjustment concerns and has a more positive outlook for herself. She is also familiar with a variety of community resources and has become not only an advocate for others but for herself. She thanked the IL Counselor for the support, encouragement and services she received.

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

As stated in the FY 12 70B report, the Independent Living Services Program within the DSU continued to experience on going changes throughout the fiscal year, which significantly impacted the administering and management of services relative to the ILOB program. In fiscal year 2013,the MOU between DDS and the DC Office on Aging was not fully implemented until April, the data base system, System 7, has not yet been fully customized to capture a lot of the service categories, forms and letters still do not include IL language, along with other glitches that impacted timely delivery of services. IL policies and procedures have still not yet been clearly defined by the agency, which also affected the service delivery process. While one of the recommendations sited within the FY 2012 independent contractual review of the organizational structure of the Division Services for the Blind, was that the general IL Services program not be operated under the Division Services for the Blind, only IL services relative to the blind be administered under this specialized Division. A decision was made by the executive management to dissolve the Division Services for the Blind, and establish a sensory impairment unit that would include the administration of general IL and ILOB services within this unit . Despite these barrier and organizational changes, significant internal commitment to improve services to older blind and deaf blind consumers in FY 14 are already underway, which will include expanded technology and O&M training, and service coordination for special support persons to assist deaf blind seniors and adults are currently being implemented

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 byAndrew Reese
TitleDeputy Director
Telephone202-442-8606
Date signed01/03/2014