From Sunday's Pittsburgh Post Gazette
http://www.post-gazette.com/regionstate/20000903Blind8.asp
State rank slow in service for the blind
Sunday, September 03, 2000
By Steve Levin, Post-Gazette Staff Writer
Job uncertainties are only one of many stumbling blocks for blind and
visually impaired people in Pennsylvania. Low state funding for
programs for the blind, a state bureau long hindered by government
bureaucracy and a revolving door of state directors have left
Pennsylvania near the bottom of states in the quality of overall
services to the blind and visually impaired.
In addition, two former directors of the state Bureau of Blindness and
Visual Services allege that millions of dollars in federal
reimbursement money was kept from the bureau by the state Department
of Public Welfare, the longtime overseer of the blindness bureau. A
year ago, responsibility for the blindness bureau was transferred to
the state Department of Labor and Industry. The move has pared some of
the bureaucracy, observers say, but the basic problems remain.
"I think what has happened is that among blind people, a lack of
confidence in the state agency has developed," said John Horst,
executive director of the Pennsylvania Council of the Blind, an
advocacy agency for blind and visually impaired people with 20
chapters across the state.
"Pennsylvania hasn't had the kind of leadership it has needed to push
the issues of blind people," said Alberta Orr, chair of the American
Federation of the Blind's aging program. "When you look at services
for [blind] people around the country, [blind] people in Pennsylvania
are getting a bad deal. They're really not getting the services other
people are getting. Pennsylvania is pretty low on the list."
Officials with DPW, including Secretary Feather O. Houstoun and deputy
secretary Bill Gannon, declined to be interviewed for this story.
Buried in a bureaucracy
In Pennsylvania, the Bureau of Blindness and Visual Services is the
primary state office responsible for delivering vocational
rehabilitation, mobility training and social services to the blind and
visually impaired. Founded as the State Council for the Blind in 1925,
in 1958 it was renamed Office for the Blind and placed under the
oversight of the Department of Public Welfare.
The Welfare Department has grown into the state government's largest
agency. It employs 23,000 people, has a $13 billion budget (38 percent
of the state budget) and oversees everything from food stamps and
welfare reform to child abuse and the licensing of mental health
providers. Until its move last year, the blindness bureau existed as a
tiny part of it.
Under a complicated federal formula, state rehabilitation agencies
receive federal Title I money from the Rehabilitation Services
Administration based on funding levels from their state legislatures.
Norm Witman, director of the blindness bureau from 1988 to 1995, said
that he repeatedly requested state budget levels that would trigger
maximum federal funding allotments. Despite that, he said, the Welfare
Department never requested the full match from the state, resulting in
"several hundred thousands" of dollars that he estimates the bureau
missed out on annually during his seven years as director.
"We were buried so deep in the bureaucracy we didn't have much clout,"
said Witman, one of five directors of the blindness bureau in the past
five years. Witman is now director of administrative services for
Keystone Community Health in Harrisburg. "The message was that the
bureau of blindness was a stepchild."
A welfare department spokeswoman said no records of the blindness
bureau's original budget requests were available.
The Title I money that comes to state also is known as Section 110
money. It is disbursed through states' "designated" vocational
rehabilitation agencies; in Pennsylvania, that is the Office of
Vocational Rehabilitation. Around the country, these primary
rehabilitation agencies keep the bulk of the Section 110 money because
they are responsible for all rehabilitation programs except blindness.
But on average, blindness bureaus nationwide receive about 14 percent
of the Section 110 money given to designated rehabilitation agencies.
Yet during the past 10 years in Pennsylvania, the figure has been 10
percent or less, with OVR keeping the rest. For example, in 1999, the
bureau of blindness received $10.3 million in Section 110 money out of
more than $103 million; OVR kept the rest.
"Pennsylvania has historically been very extremely low" in its Section
110 funding, said Joseph Cordova, director of the division for the
blind and visually impaired, part of the Rehabilitation Services
Administration under the federal Department of Education. "I don't
think you're going to find anybody [giving] less. That is the lowest
amount."
"It does tie your hands in terms of growth," said Doug Boone, director
of the blindness bureau from 1997 to 1998, and now a consultant in
Mechanicsburg, Cumberland County. "In order for the agency to meet the
true needs of the citizens of the commonwealth, in my opinion the
bureau needs a greater share of the federal 110 monies."
Boone's wife, Christine, left a job as a lawyer for the Department of
Labor and Industry in June to become director of the blindness bureau.
She is blind.
For the preceding year, Rose Putric, a 19-year bureau employee, was
acting director. For the previous nine years she worked closely with
the bureau's budget. Putric said that while "it's possible" the bureau
never drew down its full complement of federal money, during that same
time it never spent its total budget. Each year over that 10-year
period, the bureau underspent its annual budget by an average of about
$61,000.
"If you can't spend your total budget that you had, how are you going
to spend these additional funds?" she said.
Following the money
Each year, the blindness bureau's rehabilitation counselors
successfully train and find jobs for an average of 21 blind
Pennsylvanians who previously had received Supplemental Security
Income or Supplemental Security Disability Income. Most have
disabilities in addition to blindness. The jobs allow them to become
taxpayers and stop receiving federal money.
Much of the money spent by the blindness bureau during this
rehabilitation process is reimbursed by the federal Social Security
Administration. That money is supposed to go to the bureau and be used
to develop new programs.
But Witman and Bob Eshbach, who was director of the blindness bureau
from 1995 to 1997, allege that at least $4 million in federal
reimbursement money that should have gone to the bureau for program
development during their tenures was instead kept by the welfare
department as a hedge against budget shortfalls.
During his nearly three years as director of the blindness bureau,
Eshbach said, the welfare department withheld more than $2 million in
reimbursement money. He recalled a proposal for a $200,000 program
that would have expanded senior citizens' ability to continue to live
independently.
"[Welfare department officials] said they couldn't fund it out of the
SSA funds because [the program's funding] was an unpredictable
amount," said Eshbach, who retired after leaving the bureau. "They
used the excuse, 'What happens if we don't get that much [SSA money]
in [next year]? Then you can't continue your program.'"
During Eshbach's time as director, the bureau of blindness never
received less than $324,898 from the Social Security Administration in
any one year. In fact, since 1989, the bureau hasn't received less
than $224,000 in federal reimbursement money in any year.
Witman said that the bureau "never saw anywhere near in a given year
what we earned."
Both Putric and a spokeswoman for the Welfare Department deny that any
reimbursement money was withheld. Putric said that during the period
she worked on the bureau's budget -- 1990-1999 -- "my experience is
that we did" get the federal reimbursement money.
Strength in separation
Ted Young, for 10 years president of the state's chapter of the
National Federation of the Blind, realizes that bureaucracy is an
unavoidable part of government. But the situation of Pennsylvania's
blindness bureau is exacerbated, he said, because of its subordinate
relationship with its administrative agencies.
"I had to climb a ladder to reach the brain of that bureaucracy," said
Young, who distributes adaptive equipment and trains clients in its
use through his Glenside, Montgomery County, business called Young
Opportunities. Young and many others believe that the blindness bureau
would be better served if it were divorced from OVR.
National studies have shown that states with separate agencies for the
blind have better training and employment results than states
combining blindness bureaus with other agencies. In addition, a 1999
Mississippi State University study of more than 35,000 legally blind
Americans concluded that separate agencies provide more services and
rehabilitate a higher percentage of clients than combined ones. Also,
the average earnings of blind clients in separate agencies are higher.
Twenty-four states have separate agencies; the rest, including
Pennsylvania, Ohio and West Virginia, have combined agencies.
The reason combined agencies don't fare as well, said James Gashel,
director of governmental affairs for the National Federation of the
Blind, is that "they don't have targeted services.
"They're so mixed in with other programs that they don't have any
focus. The funds aren't being directed toward the specific needs of
blind people."
The critical element for an agency for the blind, said Brenda S.
Cavenaugh, author of the Mississippi State University study, is the
training it provides clients. The training of the blind differs from
other disabilities, said Cavenaugh, a professor at the university's
Rehabilitation Research and Training Center on Blindness and Low
Vision.
"It's something that just can't be done by your traditional vocational
rehabilitation counselor," Cavenaugh said. "They don't have the
training for it."
The loss of sight requires a complete readjustment to living, more so
than the loss of a limb or a paralytic injury, Cavenaugh and others
said. While medical, psychological and physical therapy costs
associated with losing a limb are usually covered by insurance, with
blindness, "nothing is out there," said Jim Antonacci, Pennsylvania
president of the National Federation of the Blind.
"The only game in town is vocational rehabilitation through the
state," he said. And the cost of blind rehabilitation is higher than
that for other long-term disabilities because many expenses are not
covered by Medicare and other health insurance, he said.
OVR policy changed June 1 to require that blind and visually impaired
Pennsylvanians be charged for skills training, adaptive equipment and
job search help they formerly received free from the blindness bureau.
The amount must be paid each year a service is used, and increases on
a sliding scale according to a family's income. (A family of three
earning less than $25,000 annually is not charged.)
"The reason [the charge] is pretty severe is that it's so early in the
rehabilitation process," said Horst, of the state Council of the
Blind. "Blindness skills training such as grooming, cooking and
getting around are very beneficial.
"Unless these are provided, he or she is not going to be qualified [in
the future] for work."
Rep. Lita Indzel Cohen, R-Montgomery, has sponsored a bill that would
create the state Commission on Blindness and Visual Impairment. The
nine-member commission would be responsible for rehabilitation,
referral services and information to the state's blind and visually
impaired residents. It would be under the authority of the governor.
Cohen's bill is under consideration by the House Health and Human
Services and Labor Relations committees.
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