NOTIONS

By Nancy Johnson

Vision Loss an Increasing Public Health Problem: As the American population ages, vision loss is becoming a major public health problem. The issue is serious enough that a substantial increase in blindness and low vision is expected by 2020, according to a new series of studies. Published in the April issue of Archives of Ophthalmology, the studies show blindness or low vision now affects 3.3 million Americans Ages 40 and older, or one in 28 people in that age group. The number will jump to 5.5 million by 2020, according to the studies. Because the risk of vision loss increases with age, more Americans will be at risk because a larger proportion of the population will be older than 40 in the coming decades. As with many health conditions, there are racial and ethnic disparities when it comes to eye diseases. [Webscape Weekly, 6-22-04]

I don’t understand what our state leaders are thinking. Visually impaired and blind Kansans have been reaping the benefits of rehabilitation for generations now. Yet there appears to be an on-going effort to curtail services to this population at all levels. KABVI’s stated mission is "To make every blind Kansan a self-sufficient citizen." The organization has struggled long and hard to help this happen. Yet, when times get tough, it appears that this population is a major target for funding reductions.

We continue to hear (rumors, we believe) that the Kansas Rehabilitation Center for the Blind (RCB) will be closed. Its services have been limited now to primarily those who plan to enter the workforce. Those who have put in their years there and those who (for reasons of health or multiple disabilities) cannot work, can seldom now avail themselves of RCB’s training. These are the people who will ultimately find themselves in long term care facilities or receive in-home services paid for by Medicare or Medicaid – extremely expensive, federally funded programs.

Kansas has an excellent service system in place for persons who develop severe vision impairments and blindness. It’s a part of the Department of Social and Rehabilitation Services (SRS) - which isn’t called the Department of Social and Vocational Rehabilitation Services. But because most of the money for its programs comes through vocational rehabilitation (VR) funding, the emphasis seems to be on employment to the near exclusion of the rest of the blind and severely visually impaired population. Kan-SAIL (Kansas Seniors Achieving Independent Living) is a federally funded program that provides minimal – but extremely valuable - services to severely visually impaired individuals ages 55 plus. The Rehabilitation Teaching Program has seven specialists stationed across Kansas who provide in-home training and has traditionally been a cradle to grave program. That program, however, is funded primarily with VR money, so emphasis is placed on serving individuals preparing for employment.

Everyone who can work should work. And everyone who can live independently with minimal assistance should live independently with minimal assistance. The reality is that money is tight and we’re all taking our hits. Are we all trying so hard to do “more with less” that we haven’t time to consider the long term results of some of our decisions? Has anyone compared the cost of long term care to the cost of teaching comprehensive, adapted techniques for living independently? Is any effort being made to find alternative funding streams?

We realize change happens and efforts are being made to maintain services within the available budget. But it does feel as if we’re backsliding. Those of us who have enjoyed the benefits of a really good service program do not want to see the direction reverse. Visually impaired and blind people have proved their abilities to benefit from rehabilitation – vocational or non-vocational. We’ve seen public understanding and attitudes toward us gradually improve. Reversals will happen if we don’t find ways to help those coming behind us. KABVI is not willing to allow those reversals to happen. Are our state legislators and leaders within SRS? Only time will tell.