A Summary of Services Provided by Chapter 2 Programs: A Review of Older Individuals Who Are Blind Annual Performance Report Data from Years 2008-2013

Policymakers have failed to prioritize services for individuals facing vision loss despite the implications that include increased risk of falls, injuries, depression, and social isolation, and the heightened effects of other health conditions (National Academies of Sciences, Engineering, and Medicine, 2016). This lack of prioritization could particularly affect an aging population. By 2030, 60 million baby boomers will be between the ages of 66 and 84 years. More than 20% of the United States population will be over the age of 65 (Brandon, 2014), compared to 13% of that population in 2010. Since advancing age is associated with higher prevalence of vision loss, the Independent Living Services for Older Individuals Who Are Blind programs will likely face an increasing demand for services. The Rehabilitation Act of 1973 established the framework for funding services to individuals aged 55 years and older who faced vision loss and did not have employment goals. Recognizing that this group of individuals could benefit from services to help them maintain independence in their homes, the Title VII, Chapter 2 legislation, which authorizes rehabilitation services for persons who are older with vision loss, was first funded in federal fiscal year 1987. The initial funding of $5 million was not available to all 50 states (Rogers & Orr, 1999). However, in fiscal year 2000, funding reached $15 million and The contents of this publication were developed under a grant from the Department of Education, Rehabilitation Services Administration (RSA) grant number H177Z150003. However, these contents do not necessarily represent the policy of the RSA, and readers should not assume endorsement by the federal government. crossed the threshold to become a formula grant program (The Rehabilitation Act of 1973, as amended, 1999). Formula grant status allows all U.S. states and territories to receive funding, with a minimum allotment to states of $225,000 and territories of $40,000 (Rehabilitation Act Amendments of 1998). Although the transition to formula grant status was a tremendous success for advocates, no reviews of the subsequent reports have been undertaken to examine its effectiveness. Several articles addressed the overall need for more Older Individuals Who Are Blind program services and called for better collection of outcome data (Cavenaugh & Steinman, 2005; Head, 1998; Rogers, Menchetti, & Lai, 2000). However, there are only a few articles that indicate the average number of people served and the cost of those services. In one study, Herndon and Landry (1995) specifically reviewed Older Individuals Who Are Blind program data from a three-year period and reported the number of individuals served by age, race, gender, incidence of other disabilities, and types of services received. Based on data from 28 states, that study reported that the average number of individuals served per state was 518, with a mean expenditure per person at $500. In another study, Moore and Sansing's 2005 report (as cited in Moore, Steinman, Giesen, & Frank, 2006) provides data for all 50 states and territories for fiscal year 2004, where an average of 1,159 individuals were served per state or territory. Our investigation reviewed data from all 50 states receiving Title VII, Chapter 2 funds to document the changes in the number of people served and the cost of services, and to examine the ability of the current system to accommodate the expected increase in need for services. METHODS Agencies receiving Title VII, Chapter 2 funds must complete an Older Individuals Who Are Blind Annual Performance Report (RSA 7OB) each fiscal year, and submit the report to the Rehabilitation Services Administration (RSA). The reports are published on RSA's website, , which is made available to the public at large. For our study, a dataset including grant and state funds, funds expended, direct services, number of individuals served, age, gender, race, level of vision impairment, type of eye condition, other age-related health conditions, living situation, referral source, types of services, and service outcomes for each state for the years 2008 to 2013 was manually transposed to an Excel spreadsheet and imported to SPSS (23) statistical software for analysis. …