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Cost Effectiveness of the OIB Program

It is estimated the OIB programs are touching 1.4-5% of the eligible population of older persons with vision loss. We are serving a very small number of eligible persons, and our programs are often maxed out with waiting lists. We need more funding and more qualified personnel. There are several groups working on this – The Agenda on Aging and Vision in the 21st Century that AFB is spearheading and the NCSAB OIB Committee. We are trying to gather information on how the program is cost effective – if you have examples or anecdotes to share on how the program made a difference in your state – we would love to hear them. (No client names or identifying information please!)


Janet Ford's picture

We use group meetings across the state to reach as many potential clients as possible. Working with medical professionals we acquire referrals and immediate medical information to assist in the triage process. The program is underfunded but we are able to assist a higher rate of eligible clients by utilizing group meetings, technology and working in conjunction with other service providers.
Adele Crudden's picture

It is difficult to make the case for needing more money until numbers are presented to justify it. However, many states appear so overwhelmed with meeting current needs that they don't have time to promote their programs in such a way that new clients could be identified and counted.
Matthew Haynes's picture

Here in Alabama we record in our case management system how much time of instruction was provided and the estimated cost of the devices and aides provided to closed cases. I think this this helps show the value added to the consumer through services. We also have a consumer satisfaction survey that does ask our consumers if they have thought of moving to a nursing home due to their vision loss and if they felt our services have helped them avoid nursing home care. This does show that they feel more independent and able to stay in their home. I think we need to find a metric we can capture on our federal report which shows how our instruction reduces costs in some way. We can show where the money goes and what it does, but in todays environment we need to show how our program saves money in the long run. Congress and state legistators want to see the financial return on the investment not just how it impacts the quality of life the consumers we serve.
Adele Crudden's picture

Needing a metric to support this is a very valid point. I believe there are statistics about how much nursing home care costs. I would have to investigate how specific those estimates are to geographic region. So if you are asking your consumers if your services helped them avoid nursing home care, you could report the average cost for your area and how many people avoided it. It is not a perfect measure, but it is something. What suggestions do you and others have about what might be more accurate?
Sandy Neyhart's picture

hi all! In South Dakota, we have been asking the same question on the consumer satisfaction survey "Without Independent Living Services, I would have considered moving to a facility that provides me with the care I need" which is a broad question but was designed to encompass any possible move to a facility that provides individualized care. The response to this has been tracked over a number of years and sometimes been compared to the cost of nursing home care in SD. You're right Adele - it is not a perfect measure but without any other suggestions or recommendations, we gather it to show that OIB services have at least delayed a change in a program participants living situation.
Doug Bedsaul's picture

Sandy, that is a good question to include. I'd be interested in the results. Could you tell me if it is a yes/no question, or a rating scale? Some states use a similar, and also broad, question: How would you rate the importance of services to your ability to remain independent in your own home? The answer choices are Very Important, Somewhat Important, Not Important, and Not Applicable (for those already in a care facility).
Mary Douglas's picture

To broaden the topic in reality terms and to carry out research for which AFB is a resource. . . Beyond OIB, family available is a major variable. Many seniors live with family members full or part-time. Some family members don't work, others welcome quitting their jobs to be caregivers, and some do not have economic security when they quit. Family caregivers vs. institutional care is a complicated topic. Family may feel their hours need to be counted; family may discount the care provided out of loyalty; may feel elder is happier and gets better care with family. Elder may refuse institutional care until after several hospitalizations, or severe living crises. Rural vs urban opportunities for a care network and ability and advance planning to pay for institutional care. Mary Douglas
BJ LeJeune's picture

I just looked up the stats on one random state - Wisconsin. "The median annual cost of an assisted living facility in Wisconsin is $42,451 compared with $41,400 nationally, while the cost for a private room in a nursing home is $96,725 in the state compared with $83,950 nationally, according to the 10th annual survey by Genworth Financial Inc." For South Dakota the average private pay rate for a semi-private room in a South Dakota nursing home in 2012 is $182 a day, or over $66,600 per year. The average cost for a day in a South Dakota nursing home has increased annually. The average length of stay is 2.5 years, bringing the cost of an average stay to $166,500. ( All that is to say you wouldn't have to identify too many people to equal the federal OIB award for many states. With a state like Wisconsin that would be about 5-6 people in a nursing home. For a minimally funded state of $225,000, that would be about 3-4 people. But when you consider length of stay as well it goes up pretty fast. Just a thought... BJ
Adele Crudden's picture

What ways are programs collecting information to support the argument that additional funding is needed?