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

RSA-7-OB for Louisiana Rehabilitation Services - H177B130018 report through September 30, 2013

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year422,165
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 2422,165
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)46,907
A4. Third party0
A5. In-kind194,106
A6. Total Matching Funds241,013
A7. Total All Funds Expended663,178
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs0
C. Total expenditures and encumbrances for direct program services663,178

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

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 FY675
2. Number of individuals who began receiving services in the reported FY575
3. Total individuals served during the reported fiscal year (A1 + A2) 1,250

B. Age

1. 55-59120
2. 60-64129
3. 65-69154
4. 70-74150
5. 75-79187
6. 80-84247
7. 85-89162
8. 90-9481
9. 95-9914
10. 100 & over6
11. Total (must agree with A3)1,250

C. Gender

1. Female767
2. Male483
3. Total (must agree with A3)1,250

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race10
2. American Indian or Alaska Native2
3. Asian6
4. Black or African American299
5. Native Hawaiian or Other Pacific Islander2
6. White923
7. Two or more races8
8. Race and ethnicity unknown (only if consumer refuses to identify)0
9. Total (must agree with A3)1,250

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)81
2. Legally Blind (excluding totally blind)1,010
3. Severe Visual Impairment159
4. Total (must agree with A3)1,250

F. Major Cause of Visual Impairment

1. Macular Degeneration607
2. Diabetic Retinopathy205
3. Glaucoma155
4. Cataracts37
5. Other246
6. Total (must agree with A3)1,250

G. Other Age-Related Impairments

1. Hearing Impairment300
2. Diabetes275
3. Cardiovascular Disease and Strokes217
4. Cancer102
5. Bone, Muscle, Skin, Joint, and Movement Disorders136
6. Alzheimer's Disease/Cognitive Impairment70
7. Depression/Mood Disorder33
8. Other Major Geriatric Concerns146

H. Type of Residence

1. Private residence (house or apartment)1,084
2. Senior Living/Retirement Community83
3. Assisted Living Facility49
4. Nursing Home/Long-term Care facility33
5. Homeless1
6. Total (must agree with A3)1,250

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)676
2. Physician/medical provider58
3. State VR agency8
4. Government or Social Service Agency17
5. Veterans Administration46
6. Senior Center11
7. Assisted Living Facility19
8. Nursing Home/Long-term Care facility9
9. Faith-based organization5
10. Independent Living center8
11. Family member or friend219
12. Self-referral136
13. Other38
14. Total (must agree with A3)1,250

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 95,230
1b. Total Cost from other funds 3,150
2. Vision screening / vision examination / low vision evaluation 611
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 122,744
1b. Total Cost from other funds 49,076
2. Provision of assistive technology devices and aids 1,248
3. Provision of assistive technology services 719

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 2,400
1b. Total Cost from other funds 0
2. Orientation and Mobility training 298
3. Communication skills 750
4. Daily living skills 600
5. Supportive services (reader services, transportation, personal 189
6. Advocacy training and support networks 309
7. Counseling (peer, individual and group) 313
8. Information, referral and community integration 653
. Other IL services 0

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 4,462
1b. Total Cost from other funds 2,500
2. Information and Referral 1,399
3. Community Awareness: Events/Activities 119 9,969

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) 498,261 663,178 164,917
2. Number of Individuals Served 1,292 1,250 -42
3. Number of Minority Individuals Served 407 326 -81
4. Number of Community Awareness Activities 45 119 74
5. Number of Collaborating agencies and organizations 49 66 17
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 719 100.00%
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) 690 95.97%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 183 25.45%
B1. Number of individuals who received orientation and mobility (O & M) services 298 100.00%
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) 177 59.40%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 112 37.58%
C1. Number of individuals who received communication skills training 750 100.00%
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) 572 76.27%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 200 26.67%
D1. Number of individuals who received daily living skills training 600 100.00%
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) 475 79.17%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 238 39.67%
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) 911 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) 7 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) 35 n/a
E4. Number of individuals served who experienced changes in lifestyle for reasons unrelated to vision loss. (closed/inactive cases only) 49 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) 46 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 serve consumers 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 underserved 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. ? 18 plus presentations to staff of home health clinics, rural health clinics, councils on aging, residents of assisted living facilities, etc.and other groups. ? Partnerships with 20 plus ophthalmologists around the state to conduct low vision evaluations and for the purpose of obtaining referrals ? 12 plus Presentations to state/national optometrist/ophthalmologists associations. ? 13 plus 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.” ? Over 700 visits with ophthalmologists and optometrists around the state in order to promote services ? 10 plus presentations to school aged children on blindness. ? 4 plus newspaper articles featuring older blind services and/or individuals ? 10 plus 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. ? Partnership with other government grant funded programs such as the National Deaf-Blind Equipment Distribution Program in an effort to reach more individuals who have a dual sensory loss ? 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 243 respondents, with consumers indicating the highest degree of satisfaction with services approximately 99% of the time. Only 4 respondents indicated anything other than the highest degree of satisfaction with services. 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: ? “It made me want to continue life.” ? “The Things they gave me will help me daily.” ? “The Staff was very hospitable, likeable, and helpful.”

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).

Mrs. J. is in her late 50’s and lost her vision about a year ago. She gave up her own home, and moved in with her parents so that they could “take care of” her. She didn’t think she would be able to do anything for herself because of her blindness and had become very depressed and never left her parent’s home. She initially received services in her parents’ home and learned on the first visit that she could do some things on her own, including preparing a meal and pouring herself a drink. This gave her hope for becoming independent once again, and she then attended a senior retreat and gained more daily living skills, O&M skills, and began to learn Braille.

After attending the retreat, she realized she could be independent once again, and began a plan to “get her life back.” Approximately one week after she completed the retreat, Mrs. J.’s sister called to thank the staff for “giving my sister back.” She said she is getting out of the house more and seems excited about life again, something she hadn’t seen from her in over a year.

Follow-up contacts directly with Mrs. J. indicated she is currently working to move back into her own home and is now volunteering at a local charity.

Services were provided to a 72 year-old retired nurse who has retinitis pigmentosa. At the time services were provided, she was living with her daughter; however, she was motivated to make improvements in all areas of her life. She received training in activities of daily living, orientation and mobility, low vision evaluation/services, introduction to Braille, basic computer instruction, provision of AT devices, etc.. Not only did she fully participate in all services, she quickly came to assist in motivating other members of her group, and was usually the first to volunteer for any task.

During her Braille classes, she proved to be highly motivated, studied at home, and completed lessons ahead of schedule, despite the fact she has neuropathy. She mastered uncontracted large cell braille.

She excelled in every aspect of training, and graduated with skills enabling her to handle her money independently, function safely in the kitchen and stay organized using tactual markers. She said; “I have learned so much from all the classes, it’s hard to put into words. I was amazed at how many different sounds there are just from different floors. I have my house very organized now and I can find things easily. You all have really helped change my life.”

Following completion of training, she wrote a thank-you letter, with partial text below:

“It is hard for me to find the right words to express my gratitude to all of you at the Lighthouse. It has been a pleasure to participate in the different classes and everyone is so nice, pleasant, helpful and informative. I will be always thankful because my life is easier because of you all. Thanks again and God bless you all.”

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.

Due to the limited amount of funding, we often focus our services to meet those most critical needs Related to independent living for the maximum number of individuals, and often are unable to fully address recreational and leisure activities that could more enrich the lives of our consumers.

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 byKevin Monk
TitleBlind Services Executive Director
Telephone225-219-2943
Date signed12/19/2013