describe the needs assessment process highlight needs discovered thus far describe recommendations...

Conducting Needs Assessments with People

who have Combined Hearing and Vision Loss

September 8-9, 2014by Beth Jordan and Molly Rimer, HKNC &

David Vandergoot, Center for Essential Management Services

Overview

Describe the Needs Assessment Process

Highlight needs discovered thus far Describe recommendations for

improving service delivery and outcomes

Indicate accommodations needed to include persons with vision and hearing loss in needs assessments

2Helen Keller National Center www.HKNC.org

Helen Keller National Center (HKNC)

Mission: to enable each person who is Deaf-Blind to live and work in his or her community of choice

National training center on Long Island, NY

11 Regional Offices National Registry Lifelong point of contact for information www.hknc.org or [email protected]

Helen Keller National Center www.HKNC.org

http://www.hknc.org/

mailto:[email protected]

Needs Assessment History

2010 HKNC Collaboration with NY Commission f/t Blind & VI used ARRA funds to gather needs assessment of deaf-blind constituents (strategic planning)

2012 Helmsley Grant 2013 Expand Needs Assessment to 4

other states: AZ, GA, MO & OR 2014 Analyze and aggregate data


How was it funded?

HKNC’s research is funded by a grant from the Helmsley Charitable Trust

HKNC partnered with each of the five states (to date) to collect the needs assessment data


Purpose of Needs Assessment

Provide a snapshot of current service needs

Provide consumers and key informants with a voice

Opportunity for statewide planning to address the needs/service gaps

Work in partnership with other states and HKNC to address the needs


Nationwide Initiative

7

Key = Needs assessment completed


Sept, 2014

Who were the Participants?

Consumers Teens – Senior

Adults Deaf with secondary

vision loss or Blind with

secondary hearing loss or

Deaf-Blind Diverse cross

section

Key Informants Family members Service providers

› VR counselors› Rehab teachers› Mobility instructors› Educators› Mental health › Case managers› Indep Living

mentors


The sample ofparticipants should:

Be representative of the individuals with vision/hearing loss in the state re:

Location Urban vs. Rural Age Etiology Communication methods


How did we identify participants?

HKNC National Registry State Deaf-Blind Project Child Census VR 911 codes and case files Key Informants

10

Population estimates can be derived from the state sample of the American Community Survey (ACS) conducted by the US Bureau of the Census


ACS Hearing/Vision LossPopulation Estimates by State

The percentage gradually increases with each age group

11

State # of People

% of State

Population

New York 122,684 .007%

Georgia 76,981 .07%

Missouri 55,010 .09%

Arizona 48,426 .075%

Oregon 33,942 .08%


How did we gather data?

Interviews In person or

occasionally through videophone/phone

Focus Groups 4-6 participants

each Focus groups may

be key informants or consumers

May be geographical or specific to cause, i.e. Usher syndrome

12

Participants should provide feedback via interview OR focus group, not

both


Development of Interviews

HKNC developed initial item pool for use with key informants in New York

Results were used to develop consumer interviews and focus group questions

These items were incorporated into interviews of other states to see the extent of variation across the US

Other states could add items specific to their needs and interests 13


Process Identify the participants Determine locations for interviews and

focus groups Schedule interviews and focus groups Put supports in place Conduct interviews and focus groups Utilize audio tape, notetaker and

survey results to collect data Send raw data to CEMS for coding and

analysis14


Interviews & Focus Groups

Open ended questions plus demographic data

Questions ask why? or what? Interviews last < 90 minutes All participants received $100

stipend Interviews were captured through

notetaker and audio transcript


Sample Research Questions

Have you received services from VR? I’d like for you to tell me where you’ve

received services and how that process was initiated.

What was beneficial from the service you received from VR? (What did you learn? What changes did you experience? What do you do differently now?)


Sample Research Questions

What services have helped you find a job?

If you aren’t working but want to work, what obstacles have prevented you from being employed?


HKNC Regional Rep’s Role

Familiarity/Rapport with many individuals who have vision and hearing loss

Ability to communicate directly with consumers (speech, sign language, etc)

Consistency throughout the interview and focus group process

Expertise in the Deaf-Blind field Travel expenses covered by HKNC 18


State Agency’s Role

Partner with HKNC through MOU “Hire” interpreters/CART reporters Identify interview sites Set up sites/snacks (for

interviews/focus groups) Print mailings to request participation Print materials (questionnaires,

consent agreements, etc.) Provide note takers


Results Interviews with Key Informants

› Professional Service Providers› Representatives of the Deaf/Blind

Community› Advocates› Family Members

Consumer Interviews and Focus Groups

Helen Keller National Center www.HKNC.org20

Services That are Lacking - NY Key Informants

Service LackingProf DB Adv

FamTotal

Support Service Providers11 7 8

228

Advocacy/Community Awareness, Education

10 4 6 0

20

Socialization, Recreation8 2 4

519

Technology/Equipment Services7 4 4

217

Transportation (including Paratransit)7 4 3

216

Interpreter/Communication Services6 0 4

111

Vocational/Employment Services6 2 2

010

Training for Professionals (Cultural Competency)

3 2 1 1

7

Independent Living Services2 2 1

05


Needed Service Improvements - NY Key Informants

Service Needing Improvement Prof DB Adv Fam

Total

Better Trained Professionals (Lack of signing;

cultural competency)

13 6 9

331

Limited Services for Deaf and Deaf Blind 5 4 2

415

Socialization, Recreation 6 2 3

314

Transportation 5 3 3

213

Technology Training/Services 4 5 2

213

Interpreter/Communication Services 4 2 4

111

Funding 3 1 2

17

Ongoing Support Services 3 2 0

16


Professional Training Needed - NY Key Informants

Services Providers Needs Prof DB Adv

FamTotal

Too few qualified to serve deaf blind

population

5 2 3

515

Training needed by orientation and mobility

instructors in sign language

3 3 2

210

Sensitivity training needed 4 3 2

09

Need more intense training overall 4 0 3

29

Train more SSPs 3 1 2

08

Training in adapting communication, including

sign language

3 1 1

27

Train more deafness specialists 4 2 0

17

Train more interpreters 4 0 2

06

Train more independent living instructors 2 1 0

14


Satisfaction with Specific Services - NY Consumers

Most Satisfactory Services

Frequency

Percent

Mobility Training

Independent Living

Skills

Technology Training

Job Coaching

Job Development

Interpreting

Job Training

Mental Health

Counseling

Vocational

Counseling

Total

54

42

34

25

19

13

11

10

8

216

25.0

19.4

15.7

11.7

8.8

6.0

5.1

4.6

3.7

100

24

Least Satisfactory Services

Freq Percent

Ind. Living Skills

Technology Training

Mobility Training

Job Development

Voc. Counseling

Mental Health

Counseling

Job Coaching

Job Training

Interpreting

Total

18

18

17

17

15

14

14

10

5

128

14.1

14.1

13.3

13.3

11.7

10.9

10.9

7.8

3.9

100


Benefits from Services - NY Consumers

Benefits from Services Frequency Percent

Independent Living Skills

Mobility

Employment Services

Language, Communication Services

Education

Vision/Hearing Services

Assistive Technology and Training

Work Skills Training

Helen Keller National Center

Equipment

Counseling/Mental Health Support

Total

22

22

14

9

8

7

7

6

6

5

4

120

18.3

18.3

11.7

7.5

6.7

5.8

5.8

5.0

5.0

4.2

3.3

100


Recommended Service Improvements -

NY Consumers

Improving Services FrequencyPerce

nt

Improved Response Time and Speedier Delivery of

Services

Improved Continuity of Services

More Focus on Training

Specific Focus Programs

Improved Staff Qualifications

Improved Communications

Enhanced Counseling and Case Management

More Employment Services

Improved Organizational Efficiency

Improved Staff Attitude

Better Information

Total

18

16

14

13

12

9

9

7

6

5

3

112

16.1

14.3

12.5

11.6

10.7

8.0

8.0

6.2

5.4

4.5

2.7

100


Goal Achievement -NY Consumers

Goal AchievementFrequenc

y

Perce

nt

Achieved

Somewhat Achieved

Not Achieved

Still in Process

Did not have a Goal

Missing

Total

26

31

11

6

1

7

82

31.8

37.8

13.4

7.3

1.2

8.5

100


Reasons for Success -NY Consumers

Reasons for SuccessFrequency

Percen

t

Self-Motivation

Instructor Qualities

Service that I Needed

Counseling and Support

Job Related Services

Well Designed Training

Accessible Services

Interpreting Support

Specific Training

Financial Support

Assistive Technology

Total

33

28

19

11

8

8

3

2

2

2

1

117

28.2

23.9

16.2

9.4

6.8

6.8

2.6

1.7

1.7

1.7

.8

10028


Reasons for Lack of Success -NY Consumers

Reasons for Lack of SuccessFrequenc

y

Perce

nt

Training Insufficient

Job Development Lacking

Agency Problems

Communication Problems

Counseling not Helpful

Consumer Problems

Employment Services Lacking

Problems with Assistive Tech

Total

33

14

14

8

8

6

5

3

91

36.2

15.4

15.4

8.8

8.8

6.6

5.5

3.3

100


Services Helpful for Finding Jobs - NY Consumers

Services Helpful for Finding Jobs Frequency Percent

Job Development

Job Search Assistance

Job Coaching

Job Retention Services

Counseling Support

Mobility Instruction

Skill Training

Equipment

Internships

Education about Deaf Blindness

Total

18

9

8

7

7

6

5

4

4

3

71

25.4

12.7

11.3

9.9

9.9

8.5

7.0

5.6

5.6

4.2

100


Services Helpful for Keeping Jobs -NY Consumers

Services Helpful for Maintaining

JobsFrequency Percent

Job Coaching

Assistive Technology

Interpreting Services

Mobility Instruction

Equipment

Training and Education

Communication Aids

Counseling

Ongoing Support

Low Vision Services

Job Site Orientation

Total

12

8

8

7

5

5

4

3

2

1

1

56

21.4

14.3

14.3

12.5

8.9

8.9

7.1

5.4

3.6

1.8

1.8

100 31Helen Keller National Center www.HKNC.org

Needed Additional Services -NY Consumers

Needed ServicesFrequenc

y Percent

Education/Training

SSP Assistance

Improved Transportation

Better Communications about Services

Job Development/Job Search Assistance

Ongoing Employment Support Services

Independent Living

Technology/Equipment

Mobility

Interpreting

Mental Health Counseling

Other

Total

14

12

10

8

7

5

5

5

3

2

2

6

79

17.7

15.2

12.7

10.1

8.9

6.3

6.3

6.3

3.8

2.5

2.5

7.6

10032


Services that are Lacking -MO Key Informants

Services that are Lacking Total (n=66)

Support Services Providers 8

Transportation 7

Awareness 5

Interpreter Services 4

Job Placement Services 3

Outreach Services 3

Vocational Training 3


Services Needing Improvement -MO Key Informants

Services Needing Improvement Total (n=50)All of Them 7

Education of Professionals 6

Transportation 6

Improved Outreach 5

Increased Awareness of Capabilities 5

Improved Availability of Services 3

Interpreter Services 3

Communication Skills Training 2

Employment Services 2

Improved Funding 2

Specialized Job Placement Programs 2

Support Services Providers 2


Means of Access to Services -MO Key Informants

Means of access to servicesTotal

(n=87)Family 15

Interpreters 7

Self-Referrals 7

Friends 6

Rehabilitation Services for the

Blind6

Social Service Professionals 6

Coordination Through Schools 5

Para Transit 4

Medicaid/Medicare 3

TDD 3

Regional Center Referrals 2

SADI 2

Support Service Providers 2

Telephone Relay Services 2

35

Referral Information Source -MO Consumers

Referral Information SourceTota

lFamily Member, Friend 6

School 5Vocational Rehabilitation 5

Self 5Other Service Provider 5

Doctor/Medical Professional 3RSB 2

Blind School 1Medical Provider 1

Grand Total 33


How Goals Determined -MO Consumers

How Goals Determined Total

Counseling 25

Self-directed 6

No real planning 4

Assessments 3

Agency Directed 2

Grand Total 40


Outcomes of Goals -MO Consumers

Outcome of Goals Total

Somewhat Achieved 18

Achieved 18

None 2

Grand Total 38


Satisfaction with Services -

MO ConsumersThree Most Satisfying

ServicesTotal

Mobility 24Technology 21

Independent Living Skills 14Job Training 6

Job Development 5Vocational Counseling 3

Interpreting 3Job Coaching 2

Mental Health 0Grand Total 78


Basis for Dissatisfaction -

MO ConsumersBasis for Consumer Service Dissatisfaction

Total

Unresponsive to Needs 9No Dissatisfaction 8

Lack of Counseling Support 5Lack of Technology Training and Support 4

Staff Lacked Deaf-Blind Awareness 4Lack of Direction and Information 3

Lack of Job Seeking and Job Development Support 3Lack of Independent Living Services 2

Lack of Mobility Services 2Infrequent Counselor Contacts 2

Inadequate Vocational Training and Support 2Outdated/Inappropriate Technology 2

Unrealistic Staff Expectations 1Unsatisfactory Vendors 1

Inadequate Staff Communication Skills 1Lack of Vocational Training and Employment Support 1

Grand Total 50


Satisfaction with Services - GA Consumers

Three Most Satisfying Services

Total

Technology 18Mobility 16

Independent Living Services 10Job Training 7

Job Development 5Interpreting 2Job Coaching 1

Vocational Counseling 1Mental Health Counseling 0

Grand Total 60


Basis for Dissatisfaction -GA Consumers

Basis for Consumer Dissatisfaction

Total

Lack of Information 3

Infrequent Counselor Contacts 2

Lack of Individualized Services 2

Lack of Communication 1Lack of Funding for Part Time

Education 1

Lack of Mental Health Counseling 1

Grand Total 10


Satisfaction with Services -OR Consumers

Three Most Satisfying Services

Total

Mobility 17

Technology 13

Independent Living Skills 7

Mental Health 4

Job Training 4

Job Development 2

Vocational Counseling 2

Interpreting 1

Job Coaching 1

Grand Total 51


Explanation of Satisfaction -

OR ConsumersBasis for Consumer Satisfaction Total

Independence 6Completely Satisfied 5

Staff Qualities 5Counseling Support 4

Increased Confidence 3Safety and Security 2Technology Training 2

Employment 1Employment Services 1

Learning 1Mobility 1

Moral Support 1Quality of Life 1

Technology Support 1Socialization 1Grand Total 35


Services Helpful for Finding Jobs -OR Consumers

Helpful Job Finding ServicesTota

lJob Development 6

Self-Placed 4Training 4

None 2Assistive Technology 2

Inappropriate Job Development 1Job Seeking Skills 1

Job Accommodations 1Self Confidence 1

Vocational Counseling 1Interpreter Services 1

Equipment 1Grand Total 25


Services Helpful for Keeping Jobs -OR Consumers

Helpful Job Maintenance Services

Total

Assistive Technology 7Training 3

Mobility Instruction 3Transportation 2

Computer Skills 2Equipment 2

Job Accommodations 1Job Coaching 1

Job Site Orientation 1Advocacy 1

Networking 1Communication Aids 1

Computer Training 1Grand Total 26


Obstacles to Work -OR Consumers

Work ObstaclesTota

lPersonal Limitations 11

Transportation 8Skill Deficits 5

Communication Barriers 4Health Issues 4

Discrimination 3Lack of Assistive Technology 3

Family Care Needs 2Lack of Safe Environment 2

Loss of Benefits 2Mental Health Issues 2

None 2Employer Ignorance 1

Lack of Job Search Assistance 1Mobility Issues 1Poor Economy 1

Grand Total 5247


Moderator Considerations

Understanding of the various methods and modes of communication

Experience working with interpreters Familiar with terminology and

acronyms in the Deaf-Blind Community Familiarity with the participants is

welcome but not if it influences their responses


AccommodationsInterviews: Select accessible location Scheduling (phone, VP, email, letter) Transportation Interpreters CART Materials in alternate format Questions in advance


AccommodationsFocus Groups were similar to interview needs PLUS: Multiple participants with various

communication methods Establish communication ground rules Interpreters/SSPs Use of microphone a must Include breaks to rest eyes, ears,

interpreters and allow socialization


Costs $$Use of the HKNC Helmsley Grant for: Interpreters and CART Participation fees ($100/person) Converting materials in alternate

format Interviewer/Notetaker travel Code and analyze the raw data On-Site refreshments (water, snacks,

tissues)


Recommendations

52


Process Recommendations

Moderator Role is Key› Familiar with deaf/blind culture› Familiar with local agencies and people› Knowledgeable about various forms of

communication – able to restate question or response to assist the interpreters

53


1) A Needs Assessment of people who are Deaf-Blind is a time-consuming process

2) Setting up an environment conducive to clear communications – lighting, limit distractions

3) Hiring qualified interpreters who work in the Deaf-Blind Community is a must

4) Scheduling interviews could involve email, phone, videophone or contact with family

5) Having supports in place, e.g., interpreters, transportation, SSPs, lg print/braille



6) Notetakers must type responses verbatim

7) Listening to audio transcript while reviewing written transcript is critical but very time consuming


Outcome Recommendations

1) VR should develop “Top 10 Things You Should Know about VR”

2) Consumers who are Deaf-Blind want and need the expertise of VR staff who understand hearing AND vision loss.

3) VR staff want and need Deaf-Blind Cultural Sensitivity training.

4) Involve people who are deaf-blind in the training.

5) Set high expectations!56


describe the needs assessment process highlight needs discovered thus far describe recommendations...

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