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

RSA-7-OB for Kentucky Office for the Blind - H177B130017 report through September 30, 2013

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year429,566
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year258
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 2429,824
A2. Total other federal163,508
(a) Title VII-Chapter 1-Part B0
(b) SSA reimbursement163,508
(c) Title XX - Social Security Act0
(d) Older Americans Act0
(e) Other0
A3. State (excluding in-kind)19,494
A4. Third party28,236
A5. In-kind0
A6. Total Matching Funds47,730
A7. Total All Funds Expended641,062
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs0
C. Total expenditures and encumbrances for direct program services641,062

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 0.6600 5.8700 6.5300
2. FTE Contractors 0.0000 0.0000 0.0000
3. Total FTE 0.6600 5.8700 6.5300

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 3 1.6000
2. Employees with Blindness Age 55 and Older 0 0.0000
3. Employees who are Racial/Ethnic Minorities 1 0.5100
4. Employees who are Women 8 5.1100
5. Employees Age 55 and Older 2 1.3300

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 FY120
2. Number of individuals who began receiving services in the reported FY455
3. Total individuals served during the reported fiscal year (A1 + A2) 575

B. Age

1. 55-5954
2. 60-6451
3. 65-6953
4. 70-7465
5. 75-7979
6. 80-8491
7. 85-89100
8. 90-9459
9. 95-9919
10. 100 & over4
11. Total (must agree with A3)575

C. Gender

1. Female401
2. Male174
3. Total (must agree with A3)575

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race0
2. American Indian or Alaska Native0
3. Asian2
4. Black or African American40
5. Native Hawaiian or Other Pacific Islander0
6. White530
7. Two or more races3
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)575

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)47
2. Legally Blind (excluding totally blind)333
3. Severe Visual Impairment195
4. Total (must agree with A3)575

F. Major Cause of Visual Impairment

1. Macular Degeneration322
2. Diabetic Retinopathy68
3. Glaucoma59
4. Cataracts6
5. Other120
6. Total (must agree with A3)575

G. Other Age-Related Impairments

1. Hearing Impairment68
2. Diabetes142
3. Cardiovascular Disease and Strokes153
4. Cancer10
5. Bone, Muscle, Skin, Joint, and Movement Disorders70
6. Alzheimer's Disease/Cognitive Impairment11
7. Depression/Mood Disorder6
8. Other Major Geriatric Concerns46

H. Type of Residence

1. Private residence (house or apartment)521
2. Senior Living/Retirement Community33
3. Assisted Living Facility10
4. Nursing Home/Long-term Care facility11
5. Homeless0
6. Total (must agree with A3)575

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)152
2. Physician/medical provider33
3. State VR agency42
4. Government or Social Service Agency44
5. Veterans Administration3
6. Senior Center5
7. Assisted Living Facility5
8. Nursing Home/Long-term Care facility10
9. Faith-based organization1
10. Independent Living center0
11. Family member or friend125
12. Self-referral129
13. Other26
14. Total (must agree with A3)575

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 35,236
1b. Total Cost from other funds 17,355
2. Vision screening / vision examination / low vision evaluation 382
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 212,856
1b. Total Cost from other funds 82,231
2. Provision of assistive technology devices and aids 466
3. Provision of assistive technology services 439

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 157,361
1b. Total Cost from other funds 77,506
2. Orientation and Mobility training 169
3. Communication skills 472
4. Daily living skills 440
5. Supportive services (reader services, transportation, personal 31
6. Advocacy training and support networks 23
7. Counseling (peer, individual and group) 399
8. Information, referral and community integration 315
. Other IL services 84

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 13,347
1b. Total Cost from other funds 6,574
2. Information and Referral 0
3. Community Awareness: Events/Activities 143 5,083

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) 802,828 641,062 -161,766
2. Number of Individuals Served 731 575 -156
3. Number of Minority Individuals Served 41 45 4
4. Number of Community Awareness Activities 240 143 -97
5. Number of Collaborating agencies and organizations 7 3 -4
6. Number of Sub-grantees 0 0

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 439 100.00%
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) 369 84.05%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 70 15.95%
B1. Number of individuals who received orientation and mobility (O & M) services 169 100.00%
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) 138 81.66%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 31 18.34%
C1. Number of individuals who received communication skills training 472 100.00%
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) 390 82.63%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 82 17.37%
D1. Number of individuals who received daily living skills training 440 100.00%
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) 363 82.50%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 77 17.50%
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) 454 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) 1 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) 24 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 13 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) 7 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 Kentucky Office for the Blind provides Older Individuals Who Are Blind (OIB) services through an in-house program. Services are provided through employees of the Office for the Blind and are made available in each of Kentucky’s 120 counties. During 2013, the Office for the Blind employed nine counselors assigned to provide OIB services. In addition, the OIB Program Administrator served a small number of consumers along with completing the administrative duties. In order to make services available in all sections of the state, each OIB counselor covers a large geographic area. This results in counselors traveling thousands of miles yearly to meet with consumers and to promote services through various types of outreach efforts. In 2013, OIB counselors were housed in the following OFB offices: Paducah, Owensboro, Bowling Green, Elizabethtown, Louisville, Somerset, Lexington, Florence, and Prestonsburg. OIB Counselors generally make home visits with interested persons to complete assessments and provide direct independent living services. However, if individuals do not want counselors to come to their homes, interviews and training sessions can be conducted in other community locations including One Stop Career Centers, senior centers, libraries, churches, and health departments. Counselors make every attempt to provide services/training in an environment that will be comfortable and promotes learning.

As a primary responsibility, counselors must engage in regular outreach efforts to develop and maintain referral sources. Using the agency’s case management system, counselors document outreach efforts including the type of activity and the number of persons participating. Outreach is recognized as a necessary task for counselors and is included on employee performance evaluations to be reviewed quarterly.

During 2013, counselors engaged in a variety of outreach activities. They made contacts with professionals and other community members who are likely to come into frequent contact with older persons. As stated, counselors cover large territories so they are limited as to the amount of time spent in any one city/county. The one on one contacts allow them to develop personal networking relationships with community members who continue to promote services in the absence of the counselor. In addition, counselors give informational presentations to community civic groups, consumer peer support groups, church groups. These are well received in both urban and rural communities and often lead to referrals.

Counselors participate in activities that promote awareness of services and assistive technology useful for persons with low vision/blindness. Such activities include technology exhibits/expos, health fairs, job fairs, educational seminars, etc. These events usually give persons opportunities to have hands on experience with low and high technology devices. Awareness of services is expanded along with educating persons about assistive devices that might help them increase their abilities to live more independently. These types of events are usually well attended, and counselors often receive referrals as a direct result of contacts made there.

During FY 2013, counselors served individuals living in 106 of Kentucky’s counties. Four counselors provided services and skills training to more than 80 people each. Many of these people learned about OIB services as a result of an outreach effort or by the word of mouth from someone who had received 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.

The OIB program administrator represents the Office for the Blind (OFB) on the Kentucky Statewide Independent Living Council (SILC) which promotes independent living for all persons including those age 55 and older who are visually impaired/blind. The OIB program promotes goals as outlined in the SPIL. The OIB program administrator served on a SPIL work group developing and writing the SPIL approved for the period beginning FY 2014. The program administrator has a positive working relationship with all SILC members and the directors of the Centers for Independent Living. All OIB counselors are encouraged to work cooperatively with the CILs in their geographic areas insuring consumers have access to all available services and resources.

The OIB program administrator is a member of the Statewide Mental Health and Aging Coalition. The coalition membership is made up of professionals who have direct contact with older persons and promotes activities that expand awareness of issues promoting good mental health of older people. Information and resources are shared and usually have great relevance to persons with disabilities including blindness. The program administrator has also been appointed by the Kentucky Governor to the Kentucky State Advisory Council on Libraries and represents library users who are blind/visually impaired.

OIB counselors are expected to work in close cooperation with various service providers within their assigned work areas. This is very important as counselors have limited time to be present in any one part of the large geographic area. Interaction with professionals while participating in interagency groups, diabetes educational groups, local mental health coalitions, etc. allows them to keep others informed about independent living services and to stay current themselves about resources for that local community or region.

OFB expects counselors to participate in training opportunities for continual professional growth to enhance and improve their abilities to provide services and skills training to consumers. This agency held statewide employee training in March 2013 and the OIB counselors met for specialized training discussions. Counselors have been encouraged to complete learning modules offered by the American Foundation for the Blind and to participate in a variety of webinars designed to expand counselors’ skills.

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.

The Office for the Blind completes satisfaction surveys with randomly selected OIB consumers whose cases are closed within the fiscal year. Consumers are called by an OFB employee who is not directly connected to the provision of OIB services. During FY2013, 19% (80) of the 414 consumers whose cases were closed were contacted. The survey consists of nine total question areas including two that are open ended so that respondents have the opportunity to make comments and suggestions regarding the program and service delivery. Consumers were asked if "the services from OFB met my needs" and 52% responded "strongly agree" and 44% answered "agree". When asked if he/she felt better able to do activities around his/her home, 96% responded either "strongly agree" or "agree". The same percentage stated "strongly agree" or "agree" when asked if services had increased his/her confidence to perform ADLs. The respondents were asked "What did you like best about the program?" and several people noted it was good to speak with someone who was concerned and knowledgeable. A few people noted they were pleased to receive adaptive devices such as kitchen items and learning to use tactile labeling on appliances. To conclude the survey call, each person was asked for suggestions to improve the program. Most people did not make any recommendations. A few suggestions involved ideas to expand the program if more funding becomes available. The OFB staff member who made the calls stated that most people took time to express gratitude for services received and said they appreciated participating in the survey.

In addition to the satisfaction surveys, the OIB program administrator conducts regular case reviews to help insure the overall quality of services being provided across the state. Open and closed cases are randomly selected, and when the review is completed, feedback is given to the counselor. If problems are found, corrective action is taken and counselor training provided as needed. The program administrator maintains a great deal of communication with all counselors and they are encouraged to discuss any questions or concerns with the administrator at any time so that appropriate case management is maintained.

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. P and his wife live in Western Kentucky. He has lost a significant amount of vision due to Macular Degeneration and Glaucoma. This couple was visited by an OIB Counselor and a basic assessment was completed to determine a plan of services. The counselor soon learned that one of the things Mr. P enjoyed the most is coin collecting. Due to his decreased vision, he could no longer see to independently continue his beloved hobby. The counselor conducted an evaluation and found a LED device Mr. P could successfully use. Both he and his wife were very excited that he could once again enjoy his coin research and collecting. With this success, he elected to learn other skills such as the use of writing guides and an adaptive time piece. The counselor reported that both Mr. P and his wife were happy about the increased skill level.

Ms. A is 95 years old and lives independently is an urban area. She is an author and her last book was published just over a year ago. The OIB counselor learned Ms. A has a vast amount of world experiences that she uses now for her writing and independent mindset. She was introduced to various pieces of adaptive equipment both low and high tech along with suggestions for applying adaptive methods for daily living tasks. This instruction and information enabled Ms. A to continue living in her home and writing her next project.

Mrs. W lives in Southern Kentucky. She is married and has lost vision due to Macular Degeneration. She contacted the OIB program and asked for general advice in adapting to the vision loss. The OIB counselor met with Mrs W and her husband to complete a basic assessment in order to determine a plan of services. Mr. W was very interested and participated in each training session. They practiced skills between sessions and kept notes of questions they wanted to address. One of the biggest areas of concern was mobility. They enjoy a active lifestyle and wanted to become more comfortable when taking walks in the neighborhood, attending church, eating in restaurants, etc. The counselor began instructing them how to use sighted guide walking techniques. The instruction began inside their home so Mrs. W would not be afraid of falling. When comfortable, the instruction moved outside along their sidewalk, drive, etc. As she gained confidence, Mrs. W voiced some interest in other suggested training such as learning to use her appliances with tactile labeling. Since she enjoys cooking, realizing she could operate the applances herself was very satisfying for her. Mr. and Mrs. W do most tasks as a team as they enjoy spending their time together. Since Mrs. W has gained more confidence and skills, she can more fully participate in their activities which makes both of them happier.

Mrs. F lives in a very rural area of southern western Kentucky. She is a skilled seamstress and doll maker. Several years ago, her mother received OIB services and now Mrs. F has lost a good portion of her vision. She is married and does most of the household tasks for she and her husband. When she met with an OIB counselor her primary interest was to obtain magnification devices that would allow her to read labels, etc. An evaluation was conducted and suitable devices provided so she can read most print. She was taught how to maintain her writing skills including check writing. In addition, she was taught to tactually operate her kitchen appliances and various safety tips for use around the stove, etc. Mrs. W demonstrated an ability to quickly grasp and utilize new skills and stated her appreciation for all services.

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

As available state and federal funds have been reduced, it has become more difficult to maintain the desired high quality of services. During 2013, two OIB Counselors resigned, and due to the reduction in funds, only one was replaced. As FY 2014 began, a third counselor resigned, and currently, there are no plans to fill this position. In addition, counselors experienced a reduction of caseload budget money and travel funds in 2013 and more reductions will be necessary in 2014. With fewer staff, remaining staff must carry larger caseloads and travel greater distances. This results in new referrals waiting longer for services and a reduction in the total number of people receiving services.

The reduction of funds creates difficulty for the program administrator to travel to different parts of the state to work directly with staff. This is a difficult situation when attempting to provide thorough training to new counselors. During the last few years, there are have been fewer opportunities for group training meetings for staff. In FY 2013, the independent living staff was able to meet as a group only once so the program administrator must be diligent to insure there is good and timely communications to all staff regarding program updates, policy revisions, training and technical guidance.

The Office for the Blind is a small agency made up of employees committed to providing the best service possible to all consumers. Every effort is made to maintain a high standard of direct consumer services, to document services and related costs, and to maintain accurate records.

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 byGay Pannell
TitleRehabilitation Administrator
Telephone270-746-7479
Date signed12/26/2013