The Need for an Additional $4 Million in NYS Funding to Serve Older Individuals Who Are Blind: An Overlooked Population
According to the 2019 American Community Survey of the US Census, more than 163,000 older New Yorkers age 65+ report having difficulty seeing even when wearing glasses or identify as blind. And this group of overlooked older Americans is growing. This is due to more Americans living longer, and experiencing vision loss at ever-growing rates especially among the large “Baby Boomer” generation of persons born between 1946 and 1964. Growing old with vision loss could mean falls, burns, loss of independence, depression, loneliness, and isolation. However, with access to quality vision rehabilitation services and devices, hope can be restored, independence regained, and renewed community engagement achieved.
Nowhere Else to Turn
Neither Medicare nor Medicaid, nor private insurers pay for vision rehabilitation services and devices offered by highly qualified professionals. While rehabilitation is widely available for orthopedic and many other conditions, vision-related rehabilitation leading to safe and independent living is not integral to America's public or private health care systems. Less than 5% of the eligible population likely to benefit is currently receiving such services according to the National Eye Institute.
The federal CDC indicates that age, vision loss and less movement are the biggest risk factors for falls and injuries, which result in higher ER, hospitalization, long-term care, and related costs, as well as the onset of other disabling conditions. The NYS ALP Program administered by the NYS Commission for the Blind enables access to critical services that can reduce falls, delay the need for home care or institutionalization, increase independence and quality of life while decreasing the burden carried by the public health systems, family and paid and unpaid caregivers.
When those in need don't have access to these services, accidents will occur that could cost New York State more money in the long-term than the cost of properly funding vision rehabilitation today. Surveys conducted by New York State Commission for the Blind contracted agencies show that 6 months after ALP services have been provided, 90% of legally blind elders have been able to age in place rather than experience a change in their living situations. ALP services are effective at keeping visually impaired people at home. On average, the cost to deliver ALP services is approximately $1500-$2000 per client, an inexpensive alternative to the $60,000 hip fracture resulting from a fall and the $30,0000 annual expense for nursing home care.
What does the current effective ALP Adaptive Living Program provide:
Independent living skills using specialized adaptive devices and techniques for personal and household management.
Communication skills using large print, writing guides, and time-telling devices, and using braille for reading or labeling and making notes.
Mobility skills using specific orientation and mobility techniques, long canes, and other mobility tools for safe and independent travel.
Low vision exams and special low vision optical and adaptive devices to make the most of remaining vision.
Adjustment to vision loss through counseling and connecting with and learning from others with vision loss to accept and effectively live with visual impairment.
What is the impact of an additional $4 million in state funding for ALP services (added to the current $1 million of state and $3 million of Federal funding) for non-vocational rehabilitation services administered by the NYSCB?
NYS providers of ALP services are serving only 2% of the eligible older blind population and are currently reimbursed at approximately 50-75% of the cost of providing these high impact services. $4 million of additional state funding will:
Increase reimbursement to include instruction in the latest accessibility features and applications for assistive technology such as smartphones, Alexa, etc. This training is not currently included in ALP services.
Alleviate a portion of the cost burden to current providers and minimize the negative incentive to meet additional client demand
Reach more older blind New Yorkers providing a safe and positive future
Reduce Medicaid and Medicare spending by preventing or reducing falls, accidents and the effects of social isolation.
The New York Vision Rehabilitation Association is requesting that NYS Governor Andrew Cuomo include in the state budget an additional $4 million annually for NYSCB to provide more services for more older blind New Yorkers starting on April 1, 2021.