American Foundation for the Blind Leadership Conference Recap: Some Critical Issues for Older Persons with Vision Loss
by Maureen Duffy
Guest blogger Kay McGill (pictured at left recording a Public Service Announcement) is the manager of Project Independence: Georgia Vision Program for Adults Age 55 and Over. The Georgia Vision Program is administered by the Georgia Vocational Rehabilitation Agency and provides the following services to people who are at least 55 years old and have vision loss or a combined vision and hearing loss:
- comprehensive low vision evaluations by qualified professionals
- daily living skills training by certified rehabilitation specialists
- mobility training by certified instructors
- support groups that offer opportunities to learn from and interact with peers
- assistive devices, such as talking watches, big button phones and magnifiers.
Project Independence is also part of the federal Older Blind Program, which is funded through the Rehabilitation Act. The Older Blind program, also known as Title VII, Chapter 2 of the Rehabilitation Act (Independent Living Services for Older Individuals Who are Blind), is the primary source of federal funds specifically earmarked for vision-related rehabilitation services for older adults. You can learn more about the Older Blind program at Services for Older Persons Who Are Blind or Visually Impaired at the American Foundation for the Blind (AFB).
In this guest post, Kay writes about her experience attending presentations in the aging track at the recent AFB 2017 Leadership Conference, held March 2-4, 2017 in Crystal City, Virginia. [Editor's note: AFB and the Mississippi State University National Research and Training Center on Blindness and Low Vision (NRTC) partnered to offer the conference aging track.]
Two Consistent Aging Themes Throughout the Conference
The aging track led off with two sessions on "Advancing Policy Priorities: Continuing Our National Conversation on Aging and Vision Loss" and included several other topics related to aging and vision loss. In attending the aging-related sessions, I found two themes that were consistent throughout the conference:
- There is serious concern regarding the federal budget and how it relates to serving persons (especially older persons) who are blind or visually impaired. For example, how will the increase in the Department of Defense budget have an impact on grant programs, such as the Older Blind program? [Editor's note: As long as the federal funding for the Older Blind program remains above $13 million, each state receives funding. Should the amount fall below $13 million, discretionary grants award funding to recipients on the basis of a competitive grant review process.]
- How can we meet the challenges of the continuing shortage of trained blindness professionals, especially vision rehabilitation therapists and orientation and mobility specialists?
Facts that Have an Impact on These Challenges
- 6.1 million, or 13.5%, of the population 65 and older has a vision impairment. Approximately 350,000 or .8% of those persons are blind.
- The Older Blind program has been level funded, meaning that there have been no increases in program funding, since 2006.
- $33 million dollars (the total amount nationally) of Older Blind program funding is 1% of the national Vocational Rehabilitation Program.
- The Older Blind program nationwide serves 60,000 seniors. This is "guesstimated" to be less than 2% of those persons who could benefit.
- 17 states are minimally funded at $225,000, meaning that they are capped at this level of funding through the language in the Rehabilitation Act.
Addressing These Challenges
The AFB Twenty-First Century Agenda on Aging and Vision Loss is addressing these critical issues, via specific Agenda goals:
- Goal One of the Agenda: Funding for services
- Goal Two of the Agenda: Ensuring availability and quality of professional services
- You can learn more about these Agenda goals at Goals of the Twenty-First Century Agenda on Aging and Vision Loss.
Another critically important goal of the Agenda is Goal Four: Funding for low vision devices. The purpose of this goal is to initiate a Medicare Demonstration Project to cover aids and devices for people who have low vision. There are a number of issues involved with developing such a demonstration project, however:
- Determining which devices would – and would not – be covered
- Setting the amount Medicare would pay for the devices
- Sufficient "buy-in" from eye doctors
- The fiscal impact of such a project on Medicare
- "Medical necessity" for the devices (such as for reading prescriptions)
- Overcoming concerns about a prior unsuccessful demonstration project.
Helpful Conference Sessions
Advancing Policy Priorities: Continuing Our National Conversation on Aging and Vision Loss
During this session, AFB's Dr. Rebecca Sheffield spoke about the incidence of vision loss in older people and referred people to the following websites for additional statistics and demographic information:
- The United States Census Bureau: American Fact Finder
- The United States Census Bureau: TheDataWeb
- Statistical Snapshots from the American Foundation for the Blind
Another topic covered during the National Conversation session was "Best Practices." B.J. LeJeune from the Mississippi State University (MSU) National Research and Training Center on Blindness and Low Vision (NRTC) discussed the initiative they are working on related to best practices for serving older adults with vision loss. This is being done through the Rehabilitation Services Administration (RSA) Older Individuals Who are Blind-Technical Assistance Center (OIB-TAC) grant.
Their working definition of "best practice" is the following: "Best practices are service delivery strategies or techniques that appear effective based on available evidence; are client centered; are sensitive to the context of the service delivery setting; and are responsive to evolving technology, resources or research."
MSU recently used an "expert panel" approach to develop consensus on best practices related to implementing an effective program, administrative management, and staff qualifications.
Andrew Capehart, Assistant Director, National Adult Protective Services Association, spoke about elder abuse and discussed how elder abuse is defined, the warning signs of elder abuse, the responsibilities of providers, and resources that can help. He explained that types of elder abuse can include all of the following:
- Physical abuse
- Emotional abuse
- Financial or material exploitation
- Sexual abuse
- You can report elder abuse at the National Adult Protective Services Association website.
Read Dealing with Crime or Domestic Violence as a Person with a Disability for more information on identity theft, domestic violence, and self-defense techniques.
Cultural Competence and Linguistic Competency
Suzanne M. Bronheim, Ph.D., Associate Professor of Pediatrics, Georgetown University Center for Child and Human Development, spoke about considerations in serving older individuals with vision loss from culturally and linguistically diverse groups. Her key points included the following:
- Acknowledge cultural differences
- Be aware of one's own culture
- Acquire cultural knowledge and skills
- Be aware of the connotation of "independence," depending on the culture
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