Iowa Department for the Blind
A Self-Assessment of Department
for the Blind Effectiveness
in Promoting Community Living for Persons with Disabilities
Introduction
A. Department Organization
The Iowa Department for the Blind is the state
agency responsible for providing most of the services Iowans who are
blind need to live independently and work competitively. Its
mission is to be the means for persons who are blind to obtain for
themselves universal access and full participation as citizens in
whatever roles they may choose. Because the Department is funded
primarily through state and federal tax dollars, most of the services it
offers are provided to eligible Iowans at no cost to them.
Department services and programs include:
- Library for the Blind and Physically
Handicapped
- Vocational Rehabilitation Services
- Nonvisual Access Technology Services
- Independent Living Rehabilitation Services
- Adult Orientation and Adjustment Center
- Business Enterprises Program
- Aids and Devices Store
The Department serves Iowans who have a wide range
of vision loss. In fact, most people who are blind have some
degree of eyesight. Legally, a person is blind who has a central
visual acuity of 20/200 or less in the better eye with correction or a
visual field of 20 degrees or less. The Department also considers
a person to be functionally blind who must devise nonvisual or
alternative techniques to do efficiently the things a person with
ordinary vision does with sight. An individual who is functionally
blind, for example, finds it more efficient to read books in Braille or
on cassette tape rather than in print.
The Department's programs are effective because they
are based on a positive approach to blindness. The real problem of
blindness is not the physical loss of eyesight but the misconceptions
many sighted and blind people hold about vision loss. Like the
general public, people who are blind represent a cross section of the
population. They are young and old, rich and poor, male and
female. They come from a wide variety of backgrounds and possess
varying interests, talents, and abilities. If they receive the
proper training to deal with their blindness and the opportunity to put
that training into practice, people who are blind can live independently
and work competitively as full members of their communities.
Blindness then becomes merely another physical characteristic, like
gender or height.
The effectiveness of this approach is
borne out in the lives of blind Iowans who have received Vocational
Rehabilitation services from the Department. Society benefits not
only from the skills and talents employed blind persons contribute but
also financially from the taxes they pay and the public support they no
longer require. After receiving Independent Living Rehabilitation
services, elderly and multiply disabled blind persons often decide to
stay in or return to their own homes, thereby avoiding such costly
institutional alternatives as care centers. The programs of the
Department are administered at the state level and there is no
substantial community-based effort administered by the Department.
The Department’s principal offices are located at the address in Des
Moines cited above. Offices also exist in Cedar Falls and Cedar
Rapids. Five employees are domiciled in their homes outside Des
Moines. The Department has 106.5 FTE’s and serves approximately
8,000 people.
B. Overview of Department Services and
Programs
1. Library for the Blind and Physically
Handicapped - The Department's Library for the Blind and Physically
Handicapped provides reading materials free of charge to Iowans who
cannot use standard print because of blindness, physical disability,
or reading disability. The library:
- Circulates books and magazines on cassette
tape, in Braille, and in large print to eligible borrowers
throughout the state. The Library maintains a collection of
over 90,000 book titles and makes available to its borrowers over
120 different magazines. Because the Library is a cooperating
member of the National Library Service for the Blind and Physically
Handicapped (NLS), its borrowers have access to all NLS services
- Transcribes print materials into Braille and
recorded formats. Employment-related, educational, and leisure
materials not already available in alternative media are transcribed
upon request. The Library also transcribes other magazines and
books appropriate for its collection.
- Acquires instructional and employment
materials for students and workers. The Library's
Instructional Materials Center (IMC) locates textbooks and other
educational materials for Iowa's K-12 and college students who
cannot use standard print. The IMC also locates
job-related materials for employed Iowans for whom standard print is
not an option.
- Provides independent access to the Library's
collection through the On-Line Public Access Catalog (OPAC).
Linked to the Department's web site, OPAC allows borrowers to search
the Library's collection, select books, and put them on reserve.
- Circulates descriptive videos. The
Library circulates videos enhanced with audio descriptions.
These videos range in subject from popular movies to documentaries
and in audience from children to adults.
2. Vocational Rehabilitation Services -
Vocational Rehabilitation (VR) services assist persons who are blind
in preparing for, obtaining, and retaining employment.
Applicants are made eligible based upon their visual disability,
their need for VR services, and their intent to work. The VR
counselor and the eligible individual jointly identify a vocational
goal and the services needed to achieve it. Services may
include:
- Training to help individuals achieve the
vocational goals they have selected. Individuals may need
training to acquire the skills of blindness and vocational training
or post-secondary education.
- Assessment, demonstration, and training in
the Assistive Technology Resource Center. Individuals
can explore various types of assistive technology and receive an
evaluation of their needs, skills, and resources so that they can
make informed choices about which options are best for them.
They can borrow adapted equipment from the Department's loaner pool
to help determine which items meet their training and employment
needs. The Center also develops and provides hands-on training
and training materials in the use of popular Windows applications
with screen-reading programs using keystrokes instead of the mouse.
- Job placement services. VR counselors
help job seekers develop a job-search plan, write a resume, practice
interviewing, and locate job-search and placement resources.
- Rehabilitation technology services.
Through such services as job-site assessment, procurement of
appropriate assistive technology devices, and training in the use of
adapted equipment, blind employees can perform their jobs
competitively and efficiently.
- Post-employment follow-up. After
individuals have achieved their employment goals, VR counselors can
continue to serve as a resource to both employees and employers.
Individuals can receive benefits counseling, and employers can
receive assistance in recruiting, training, and retaining employees
who are blind.
- VR staff also participate in a variety of
outreach activities. These include:
- Participation in job fairs, technology
expos, and speakers’ bureaus;
- Provision of information and training on
the Americans with Disabilities Act (ADA);
- Assessment of job sites, recommendations
for accessibility, and referral to appropriate vendors;
- Assistance to employers in producing
employee manuals and training materials in such alternative
formats as Braille, cassette tape, and electronic text;
Partnership with other training and employment programs to
facilitate the recruitment of qualified blind employees;
- Provision of guidance and training to web
masters of public agencies and programs so that web sites
available to the general public are also accessible to blind
persons.
3. Nonvisual Access Technology Services - The
Iowa Department for the Blind helps blind Iowans to evaluate,
acquire, understand, and use nonvisual access technology. Such
technology might be a talking screen reading program, which provides
nonvisual access to the Windows environment; a refreshable Braille
display, which converts data on a computer screen into a system of
raised dots (i.e., a tactile version of the screen); a Braille
embosser, which embosses material onto Braille paper; an electronic
print reading system, which converts text printed on paper into
speech or Braille; or a personal digital assistant, which enables a
blind person to take notes and process electronic information
portably using speech or refreshable Braille.
Individuals are able to evaluate nonvisual access
software and hardware in our Assistive Technology Resource Center.
They can obtain step-by-step instructions on how to operate various
Windows applications with screen access technology through the tutorials
available through our Project Assist program. They can obtain
basic training in the use of computers and PDAs for the blind in our
Orientation Center. Through job site assessments, procurement of
appropriate nonvisual access technology, and training in the use of such
technology, we help blind employees to perform their jobs competitively
and efficiently.
4. Independent Living
Rehabilitation Services - Through the Independent Living (IL)
Rehabilitation Program, elderly or multiply disabled persons who are
blind learn the skills they need to live independently and
participate actively in family and community life. By learning
the alternative techniques of blindness, they can choose the privacy
and independence of living in their own homes over moving into
expensive care centers. IL teachers and service coordinators
travel throughout the state to provide a variety of services,
including:
- Instruction in the alternative skills of
blindness. In homes and local communities, IL staff provide
individual and group training in travel with the long white cane,
Braille, keyboarding, cooking, cleaning, shopping, and leisure
activities.
- Coordination of community services. IL
staff help locate and coordinate community-based services that allow
blind individuals to remain independent.
- Provision of in-service training. IL
staff give instruction in blindness techniques to community service
providers so that they, in turn, can provide this training to the
blind individuals whom they serve.
The Department provides specialized services to
Iowans who are deaf-blind so that they, like other blind persons, can
benefit from the Vocational Rehabilitation and Independent Living
Rehabilitation services that will enable them to live and work as full
members of their communities. Staff help procure adaptive
equipment, make assessments, and arrange for educational and employment
opportunities.
5. Adult Orientation and
Adjustment Center - The Adult Orientation and Adjustment Center is a
residential training program for adults who are blind. Located
in Des Moines, the Center provides in-depth, individualized
blindness training to students so that they can return to their home
communities to live independently and work competitively in the
careers they choose. Students receive training in four areas:
- Development of self-confidence. Students learn
that "It's okay to be blind." They participate in individual and
group discussions and activities that promote a positive attitude
toward their blindness.
- Blindness skills. Students take classes in cane
travel, home and personal management, industrial arts, Braille, and
computer to learn the alternative or nonvisual techniques of
blindness that will enable them to perform everyday tasks
effectively and efficiently.
- Job readiness. Center students prepare
for competitive employment by participating in career exploration,
job shadowing, volunteering, and other job-related activities.
6. Business Enterprises Program - The
Business Enterprises Program (BEP) provides opportunities for legally
blind clients of the Vocational Rehabilitation Program to manage their
own businesses. These blind entrepreneurs manage a wide variety of
food-service operations, including cafeterias, restaurants, coffee bars,
vending locations, highway rest area vending sites, and catering.
These businesses can be found at federal, state, county, municipal, and
private locations throughout Iowa.
7. Aids and Devices Store - Located at the
Department's central office in Des Moines, the Aids and Devices Store
sells adapted items useful to persons who are blind or visually
impaired. White canes, Braille and talking watches and clocks,
Braille-writing equipment, magnifiers, measuring devices, Braille and
large-print playing cards, games, cooking and sewing aids, and other
items are available for sale. The Store also sells computer
tutorials that teach blind computer users how to access popular Windows
applications with screen-reading programs by using keystrokes instead of
the mouse. Customers can make purchases in person, by phone, or
through the mail. They can pay with cash, check, money order,
MasterCard, or Visa.
C. How Department services relate to the Olmstead
Decision and community living for people with disabilities
Most, if not all, of the Department’s services
relate to the Olmstead decision to some extent in that the orientation
in which services are delivered to the consumer are expected to be in
line with the concept of informed choice. This choice is one made
by the consumer, and this concept is found in the Department’s mission
statement, in federal law, and is reflected by the expectations of the
Department’s consumers.
D. Description of existing Department services,
programs or activities that already promote and support community living
The functions of the Library already promote and
support community living. Although the Library is open to personal
visits by those it serves, the circulation of approximately 1,000 items
daily via the mails renders it unusual, if not rare, for a patron to
physically enter the building. Other facilities, such as the OPAC,
support patrons’ ability to make decisions from their own homes. As
described above, consumer choice influences the administration of all of
the Department’s programs. The Independent Living Rehabilitation
program directly supports community living by providing services that
enable individuals to make and successfully follow through on informed
choices regarding their personal independence, living situation, and
community involvement. Working with the individual, services
needed to follow through on these choices are identified. One of
the keys services requested is specialized training in nonvisual
techniques. This training addresses activities of daily living
(i.e., cooking, shopping, and cleaning); mobility (independent
navigation of one’s environment); and communication (i.e. Braille,
recorded media, and computer). Training is provided in the
environment of choice, most typically the individual’s home, and results
in the individual’s ability to develop the skills needed to regain
personal independence, reclaim the right to self-direction, and renew
involvement in family, social, and civic circles.
V. Self-Assessment Methodology and Barrier
Identification (a plan for a systematic self-evaluation process pursuant
to Executive Order 27, in conjunction with the Olmstead Real Choices
Consumer Task Force)
In Olmstead v. L.C.,
the Supreme Court confirmed that no one should have to live in an
institution or nursing home if they can live in the community with the
right supports. As Iowa state agencies analyze their policies,
programs, statutes and regulations for compliance with Olmstead,
their frame of reference should be whether their public policies enable
Iowans with disabilities
to live in the most integrated setting appropriate to their needs.
While the Centers for Medicare and Medicaid Services has identified
certain settings as examples of institutions (e.g. state resource
centers, ICF/MRs, nursing facilities, psychiatric hospitals, residential
service facilities for children), the criteria for judging compliance
with Olmstead’s
mandate that individuals have the right to “community living” is whether
an agency’s policies enable individuals to live close to their family
and friends, live more independently, engage in productive employment,
and participate in community life. See
http://www.cms.gov/states/letters/smd1140a.asp.
A. Identification and review by each
division of Olmstead-related policies, programs, statutes and
regulations. Do these assume the Department’s services
will be provided in the integrated setting most appropriate to meeting
an individual’s needs or do they require a person to be served in an
institutional setting in order to receive services? Which, if any,
either promote or limit individuals with disabilities living in the most
integrated community settings?
B. Evaluation strategies at the
department and division levels, and timelines to accomplish each
activity:
1. Review of the Iowa Plan for Community
Development (especially the Appendix which includes the recommendations
based on public input at the 20 statewide meetings in 2001), at
http://www.dhs.state.ia.us/mhdd/MHDDReports.htm (by 6/30/03).
2. Review U.S. Department of Education
(including the Rehabilitation Services Administration) plans and reports
relating to their response to President Bush’s Executive Order 13217, at
http://www.hhs.gov/newfreedom/final/ (by 6/30/03).
3. Review selected reports from other
states relating to their response to the Olmstead Decision, at
http://www.ncsl.org/programs/health/forum/olmsreport.htm (by
6/30/03).
4. Interact with corresponding agencies in other
states regarding approaches to optimize compliance with Olmstead (by
7/31/03).
5. Collection of public input from:
a) Existing advisory boards of Department
programs (by 9/30/03).
b) Iowa disability related organizations,
including the Statewide Independent Living Council (by 9/30/03).
c) The Iowa Commission for the Blind (by
9/30/03).
6. Review the Department’s administrative
rules for Olmstead related issues
(by 9/30/03).
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