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

RSA-7-OB for Bureau of Services for Blind Persons - H177B130022 report through September 30, 2013

Part I: Funding Sources And Expenditures

Title VII-Chapter 2 Federal grant award for reported fiscal year1,004,022
Other federal grant award for reported fiscal year0
Title VII-Chapter 2 carryover from previous year229,075
Other federal grant carryover from previous year0
A. Funding Sources for Expenditures in Reported FY
A1. Title VII-Chapter 21,192,843
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)100,402
A4. Third party0
A5. In-kind0
A6. Total Matching Funds100,402
A7. Total All Funds Expended1,293,245
B. Total expenditures and encumbrances allocated to administrative, support staff, and general overhead costs0
C. Total expenditures and encumbrances for direct program services1,293,245

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 26.0000 12.0000 38.0000
2. FTE Contractors 1.0000 3.5000 4.5000
3. Total FTE 27.0000 15.5000 42.5000

B. Employed or advanced in employment

a) Number employed b) FTE
1. Employees with Disabilities 12 0.0000
2. Employees with Blindness Age 55 and Older 7 0.0000
3. Employees who are Racial/Ethnic Minorities 18 0.0000
4. Employees who are Women 36 0.0000
5. Employees Age 55 and Older 14 0.0000

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 FY221
2. Number of individuals who began receiving services in the reported FY217
3. Total individuals served during the reported fiscal year (A1 + A2) 438

B. Age

1. 55-5930
2. 60-6436
3. 65-6950
4. 70-7438
5. 75-7953
6. 80-8480
7. 85-8981
8. 90-9454
9. 95-9914
10. 100 & over2
11. Total (must agree with A3)438

C. Gender

1. Female316
2. Male122
3. Total (must agree with A3)438

D. Race/Ethnicity

For individuals who are non-Hispanic/Latino only

1. Hispanic/Latino of any race5
2. American Indian or Alaska Native1
3. Asian2
4. Black or African American44
5. Native Hawaiian or Other Pacific Islander0
6. White357
7. Two or more races11
8. Race and ethnicity unknown (only if consumer refuses to identify)18
9. Total (must agree with A3)438

E. Degree of Visual Impairment

1. Totally Blind (LP only or NLP)20
2. Legally Blind (excluding totally blind)401
3. Severe Visual Impairment17
4. Total (must agree with A3)438

F. Major Cause of Visual Impairment

1. Macular Degeneration225
2. Diabetic Retinopathy37
3. Glaucoma58
4. Cataracts8
5. Other110
6. Total (must agree with A3)438

G. Other Age-Related Impairments

1. Hearing Impairment79
2. Diabetes64
3. Cardiovascular Disease and Strokes106
4. Cancer13
5. Bone, Muscle, Skin, Joint, and Movement Disorders133
6. Alzheimer's Disease/Cognitive Impairment9
7. Depression/Mood Disorder31
8. Other Major Geriatric Concerns84

H. Type of Residence

1. Private residence (house or apartment)377
2. Senior Living/Retirement Community46
3. Assisted Living Facility14
4. Nursing Home/Long-term Care facility1
5. Homeless0
6. Total (must agree with A3)438

I. Source of Referral

1. Eye care provider (ophthalmologist, optometrist)83
2. Physician/medical provider29
3. State VR agency1
4. Government or Social Service Agency9
5. Veterans Administration4
6. Senior Center16
7. Assisted Living Facility0
8. Nursing Home/Long-term Care facility0
9. Faith-based organization0
10. Independent Living center2
11. Family member or friend79
12. Self-referral204
13. Other11
14. Total (must agree with A3)438

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 3,373
1b. Total Cost from other funds 0
2. Vision screening / vision examination / low vision evaluation 115
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 139,755
1b. Total Cost from other funds 0
2. Provision of assistive technology devices and aids 356
3. Provision of assistive technology services 60

C. Independent living and adjustment training and services

Cost Persons Served
1a. Total Cost from VII-2 funds 24,764
1b. Total Cost from other funds 0
2. Orientation and Mobility training 104
3. Communication skills 105
4. Daily living skills 150
5. Supportive services (reader services, transportation, personal 14
6. Advocacy training and support networks 10
7. Counseling (peer, individual and group) 42
8. Information, referral and community integration 22
. Other IL services 97

D. Community Awareness: Events & Activities

Cost a. Events / Activities b. Persons Served
1a. Total Cost from VII-2 funds 24,764
1b. Total Cost from other funds 0
2. Information and Referral 51
3. Community Awareness: Events/Activities 107 321

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) 1,127,478 1,293,245 165,767
2. Number of Individuals Served 1,022 438 -584
3. Number of Minority Individuals Served 244 63 -181
4. Number of Community Awareness Activities 77 107 30
5. Number of Collaborating agencies and organizations 12 14 2
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 60 100.00%
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) 21 35.00%
A3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 39 65.00%
B1. Number of individuals who received orientation and mobility (O & M) services 104 100.00%
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) 35 33.65%
B3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 61 58.65%
C1. Number of individuals who received communication skills training 105 100.00%
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) 44 41.90%
C3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 60 57.14%
D1. Number of individuals who received daily living skills training 150 100.00%
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) 53 35.33%
D3. Number of individuals for whom functional gains have not yet been determined at the close of the reporting period. 90 60.00%
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) 119 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) 2 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) 4 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) 6 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.

Over the past year, the Bureau of Services for Blind Persons (BSBP) continues to expand and increase ways to provide services to unserved and underserved populations. The Bureau is working with local area agencies on aging (Region 1b and Region 2) to identify areas of need within the communities and statewide, as well as securing interpreters and translators as needed for ESL consumers. As the population increases with multiple languages, these efforts are needed in order to meet the increasing demands for services to individuals with English as a second language. The Bureau’s efforts in diversifying its network and outreach with other professional and community partners, which includes senior centers, adult foster care agencies, Commission on Aging, and eye care professionals is to ensure that services are explained and materials are provided in order that potential consumers will be aware of the Bureau’s programs that are available to assist them in obtaining independence.

BSBP collaborated with the Lions Club to provide 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 Bureau contacted Chippewa Indian Tribe to make that they are aware of services that can be provided to seniors within their tribe. Through this contact a tour was established where BSBP staff visited the senior center and explained the independent living services that are available to individuals that are experiencing severe visual impairments.

The Bureau contracts with SVRC, Inc. to secure staff that provides independent living services to the senior blind population.

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 continues to expand and enhance service delivery to seniors with blindness and vision impairments. Through the collaboration with the various community agencies and organizations, the Bureau was able to provide services to individuals in areas where individuals were underserved, i.e. Hmongs, Native Americans and Latino/Hispanics populations. Some examples of BSBP’s efforts to expand and increase services are intensive community outreach consisting of meeting with various organizations that work with the aging population, through libraries, senior centers, senior meal sites and faith based organizations to provide information and eligibility requirements regarding the bureau’s Independent Living program. 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. The Mini Adjustment program serves as a mobile training center that enables the agency to provide training in skills of blindness to seniors who are experiencing vision loss. The activities at the mini adjustment introduce the individuals to skills that will assist them in obtaining and maintaining independence. 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 with friends and family about services that BSBP provides and as a result, the agency received inquiries.

The Bureau is in collaboration with a university that trains optometrist’s students to establish statewide internship opportunities to assist with performing low vision assessments to seniors in their home. They will work under the direction of the bureau’s vision therapist and the university’s internship coordinator. The benefits will be to make contact with consumers in less populated areas. They will also be able to assess visual needs in consumer’s homes where lighting is limited.

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 Bureau is in the process of conducting a satisfaction survey for the program and results will be available in 2014.

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).

This is 62 year old male who has glaucoma and was referred to BSBP by his probation officer when he was released from prison through the Michigan Prisoner Re-Entry Initiative (MPRI). The consumer had lost his vision while in prison and needed to learn skills of blindness to maintain his independent and live independently. The consumer was required to live in a transition house in Escanaba when he was released and the rehabilitation teacher worked with him on using an id white cane, basic orientation and mobility to rely on points of reference to locate places and things, utilized magnifiers to read bills, letters, cards, and other printed materials. We addressed money identification and check guides, writing guide techniques, talking clock and watch, and learned to label products for identification.

Then after a 3 month the consumer decided to move to Menominee to find his own apartment to be closer to his family in Green Bay. The consumer did a great job of organizing his apartment to make it easier for him to live there. Together we labeled his microwave and pizza oven, and plugged in a new large button phone for easy viewing of the numbers to call his family and friends.

The consumer is always out and about visiting the Menominee Senior Center or doing his grocery shopping at Angeli’s County Market. He has a positive attitude, resilient, eager and persistent to enjoy his life. He is truly living a life of independence. You would never know he is a person with vision impairment. He is a shining example of independence.

The rehabilitation teacher first began working with this IL consumer in March 2013. After completing the teacher assessment it was evident he was comfortable with his situation and only wanted to learn ways to organize his research for his medical practice. He is a retired pediatrician that first learned he had retinitis pigmentosa upon enrolling into medical school. He explained that he did not allow his eye condition to hinder his life. In fact he indicated he never quite focused on his eye condition until it begun to impact his daily living. At the initial assessment the RT described various devices that could assist him in reading his journals and documenting research. He felt he did not want to learn much about technology. The RT convinced him to try the digital recorder. Within a week of being introduced to the digital recorder, he had become natural with the device. He learned to navigate and record his notes onto the recorder. He also used the digital recorder to complete a speech he gave on “mobility” to his local support group. Following the speech he even spoke about his digital recorder. Upon learning the digital recorder he was ready to learn more. The RT completed a second assessment and to this my surprise he was open and excited to learn and train in new areas. He is currently learning the key board through talking typer. He signed up to attend the training center this October. He is excited to learn to use a computer and work with JAWS. He also completed finer diner training, mobility lessons and some kitchen training. He is open minded to continue to learn and train in new areas and his zest for life and commitment to research.

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

The Bureau continues to work to improve data entry and data collection for this program.

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 signed12/20/2013