Implementing an Effective Program

The eight focus areas of best practice that were considered by the Task Force under Implementing an Effective Program included the following:

1. Prioritizing service

2. Consumer eligibility

3. Prioritizing consumers

4. Managing cost of assistive devices

5. Prioritizing assistive devices provided

6. Cultural competency

7. Community outreach

8. Use of para-professionals and volunteers

Here are some of the discussion points that are being considered by the Task Force.

Prioritizing Services: A variety of services are permissible for OIB programs to provide, but not all are required. With the factors of an expected increased demand for services and limited resources, we are asking you to assist in ranking the importance of each service. If a program is underfunded and has to limit services, what is most important? Additionally we will seek to define a best practice description for each service, and an acceptable level and unacceptable level if the best cannot be reached. This information will help program managers focus on how to measure their current services and improve them.

Consumer Eligibility: The law defines consumer eligibility for OIB services as those who are 55 or older and have vision loss. It is intended for those who do not have a goal to return to work, but some states will open cases of those age 55 and older in both OIB and VR programs if they have employment goals. One of the most varied parts of eligibility is the visual requirement, ranging from 20/30-1 to legal blindness. Documentation requirements vary widely as well. Should an eye report be required to ensure the individual has sought medical care for their vision loss?

Prioritizing Consumers: Parameters for caseload management look at factors that affect program management, like caseload size, geographic area, and consumer need. In a resource restricted environment, what is best practice in terms of prioritizing who should receive services first? Is there a best way to organize caseloads to see more consumers? Are there strategies for determining most need? What is best practice, and what is acceptable?

Managing the Costs of Devices and AT: Managing the costs and procedures for ordering and providing assistive devices is handled differently by each state. Some states limit the amount spent per consumer while others give a set amount to each teacher for their entire caseload. Some states order devices in a central location, usually from specific vendors, and maintain a warehouse of devices that can be requested for consumers. Others require financial means testing with a sliding scale for some devices or get third-party support (e.g. Lion’s Club, I Can program, etc.) for some types of devices. Is there a strategy that is best? How important is training on the use of various devices? Is there a plan on how to keep staff up to date? Who maintains ownership of agency purchased AT and who is responsible for warrantees? What about Wi-Fi or cellular services?

Prioritize Provision of Assistive Devices: Many different devices are provided to consumers during the course of OIB services. With the baby boomers, there is an increased interest in technology – particularly tablets and smartphones. Other devices may include such items as magnifiers, talking products, large print or high contrast household items, crockpots, and electronic magnifiers to name a few. Are some of these items more valuable to consumers and their OIB services? Should OIB programs stick to providing specialized assistive devices? Some programs now provide iPads. Is this the best use of funds? In the current environment of looking for efficiencies, is there a best practice for identifying which products are essential to the rehabilitation process?

Cultural Competency: There are so many needs for OIB services that adjusting outreach and service provision to include sensitivity to underserved and minority cultures is often pushed to the back burner. What are some strategies for reaching out and providing culturally competent programming? Training for existing staff, acquiring interpreters to present services in relevant language, culturally specific peer support groups, use of para-professional members of the community, or collaborations with community based cultural centers are all examples of strategies. What the best ways to reach these groups?

Community Outreach: Community outreach is important for informing other professionals, and members of the community, about age-related vision loss, resources for individuals facing vision loss including OIB services, and tips for helping individuals with vision loss. Are there strategies that would make these efforts more effective? Some OIB programs have hired a specific person to do community outreach, while others have compiled a database of agencies and require staff to complete a specific number each year. Using a central database could help ensure outreach is spread as widely as possible. What other strategies could work, and could any of them be considered a best practice?

Use of para-professionals: Para-professionals have long been a discussion topic in the field of vision rehabilitation. Should they be used? What tasks are appropriate for them to do, and under what type of circumstances or supervision? When should other professionals, not in the blindness field, be consulted for assistance in part of the instruction or reinforcement? Finally, there are many opportunities where family members or volunteers could be helpful in service provision. Whether formally or informally organized, what is appropriate or best practice for using them?

The work groups are finalizing their areas of consensus and when these are completed, we will send them for comment and post them here for your review. That should be in place by July 1, 2017.