NCAVI – An Eye on Independence

It’s easy to take our sight for granted if we still have it. For many of our North Country neighbors, blindness or vision impairment is a reality they wake up to every morning. Luckily, the North Country Association for the Visually Impaired (NCAVI) is here to help.

“Blindness isn’t something that is top of mind unless you or someone you know faces the challenges of vision loss,” said Amy Kretser, executive director at NCAVI. “The people we work with every day are some of the most brave, strong and independent people I will ever meet in my lifetime.”

January 2018 is a milestone for Kretser. This year, she is celebrating the start of her fifth year as the leader of NCAVI. “People always ask me how or why I began working for an agency that helps people who are blind,” said Kretser. For many of us, the response to such a question would likely focus on career or professional identity. For Kretser, the answer is much more than that. She is motivated to wake up every day knowing that her work makes a positive difference and supports a mission she strongly believes in. At the same time, she loves the fact that she has enough room in her life to balance being a mom— “the most important job”—and being a professional.

One of Kretser’s close teammates is Jodi Lattrell-Burns, who serves as the executive administrator at NCAVI. LattrellBurns serves as the main liaison between the NCAVI office and the New York State Commission for the Blind. She also leverages her education and passion for art to facilitate classes for residents all across the North Country.

An Overview
NCAVI is one of 19 other private partner agencies that the NYS Commission for the Blind contracts with to provide services. State and federal funding comes through the commission, which distributes it to each of the agencies so it can perform its work throughout the state. Every agency is certainly bound to face unique challenges; one of NCAVI’s biggest is the size of its coverage area, a region comparable to the size of New Jersey.

“NCAVI works with hundreds of people every year in Clinton, Essex, Franklin, and St. Lawrence Counties, and I’m positive there are many, many other people who do not know that our services are available. They are free and they can make a huge difference,” said Kretser.

There are serious life changes that occur when someone is determined to be legally blind. “Transportation becomes a massive barrier and daily living in general requires a lot of adaptations,” said Kretser. This is where the support system at NCAVI can make a huge impact. “The bulk of what NCAVI does is to provide people support, training, equipment, and instruction so that they can adapt their lives and attain or maintain their independence,” said Kretser.

The Dynamic Duo
Eileen Brennan and Pat Wilson are the two specialists at NCAVI who help those who are blind or visually impaired in Clinton, Essex, St. Lawrence, and Franklin Counties.
Their experience and skill sets are invaluable to NCAVI. “We are not an agency prepared to pay thousands of dollars for adaptive equipment for each person we help,” said Kretser. “But what we can guarantee is that our specialists will provide services that people can use all the time, anywhere.”

The certified team at NCAVI understands the fear that can set in once someone is determined to be legally blind, and they are able to leverage their expertise to help someone adjust. “I’ve seen the impact our specialists and therapists have,” said Kretser. “I’ve met so many remarkable people who use the services we offer and who are able to adapt and adjust. Blindness is not who they are, it’s just something they continue to work around.”

A Holistic Approach: Helping Patients Adapt
NCAVI provides two major services: 1) Orientation and Mobility Support and 2) Vision Rehabilitation Therapy. The centerpiece to these successful programs is staff who have Master’s degree-level education specific to facilitating vision therapy programs.

“Orientation and mobility is generally what it sounds like— how people get around and know where they are in relation to where they want to go,” said Kretser. “The staff work with people to instruct them on how to use a white cane, how to access transportation, and how to orient themselves to their work, home, or community.”

Vision Rehabilitation Therapy addresses daily living skills. “Think personal care—taking care of the home, cooking, paying bills, etc.,” said Kretser. Often these are the skills that can be taken for granted until our vision is impaired. The team at NCAVI helps patients through this challenging and stressful time, helping them adapt and regain their independence. “The technology can be useful, but the skills Eileen and Pat teach are truly priceless,” said Kretser.

New Programs to Increase Engagement

NCAVI is working on some new programs as well, such as job placement services. “We are exploring ways that NCAVI can help people who are blind find employment.
There are plenty of well-educated and very talented people who have used NCAVI’s services to continue or change their career paths,” said Kretser. “Our organization wants to be sure that people who want to work have access to support that will help to make that happen. It’s an exciting program.” There’s also a relatively new program called “Access Adirondacks,” which was started only a few years ago as a way to help connect blind or visually impaired people in the area. “It was started in order to find ways to bring these people together to enjoy the beauty of where we live,” said Kretser. The program has allowed for a wide variety of programming, such as hiking the Adirondacks, going on birding expeditions at Paul Smith’s College, and engaging in the arts.

The Strand Center for the Arts has become a major supporter of Access Adirondacks as well. Kretser and Lattrell-Burns were able to combine their skill sets to kick-start the program. Through Kretser’s grant-writing and Lattrell-Burns’ degree in fine arts from SUNY Potsdam, NCAVI has been able to implement mobile art classes across each of the four counties they serve. “We have several local blind artists who put work in our annual exhibit at the Strand Center for the Arts. They love this program!” said Kretser.

Staffing the Team at NCAVI
“The journey, like any other, is never 100 percent smooth and we hit roadblocks all the time,” said Kretser. Her team continually faces a handful of challenges that keep them on their toes for the North Country residents they serve. “One of our biggest hurdles is finding staff who are certified Vision Rehabilitation Therapists and Orientation and Mobility Specialists. Our contract with the state requires us to have these specialists and they are hard to find,” said Kretser.

Certification takes commitment, requiring a Master’s degree earned specifically within the vision rehabilitation field. The candidate pool becomes slim after that requirement. Then add on another layer of complexity: they need to live (or have an interest in living) in the North Country. It’s a problem that is not unique to NCAVI, however. There is a shortage of certified professional in the vision rehabilitation field statewide.

“Last I checked, there were over 20 vacancies in the 19 agencies,” said Kretser. “I have been working with the commission to forge new ground for our agency.” NCAVI is exploring ways it can support students in the Occupational Therapy program at Clarkson University, for example. Many students are required to complete fieldwork, which could facilitate a valuable opportunity for both NCAVI and students to accomplish their respective goals.

“With a more intensive focus on vision rehabilitation, OTs [occupational therapists] may be a viable and solid alternative,” said Kretser. There’s a continuous need to identify new and creative solutions so that patients are given the services they need by qualified professionals.

A Shortage of Doctors

According to Kretser, there’s also a major shortage of doctors in the region who continue to renew their Low Vision Certifications. “To my knowledge there were only three, and in March, it will be down to two, in 7,500 square miles. It’s crazy,” said Kretser. The recurring factor involved appears to be insurance coverage. Low vision exams require more testing and longer appointments in order to properly identify the specific magnification or adaptive equipment a patient might need.

“Insurance doesn’t reimburse the exams at a rate commensurate with the extensive time and effort it takes to provide one exam. The result is that many people who are blind in the North Country will need to go downstate for an evaluation,” said Kretser. “We cannot thank the doctors who maintain their certification and provide those low vision exams enough.”

NCAVI sees a disproportionate number of senior citizens as well, which opens up a conversation about Medicare coverage. “One of the head-scratching issues we face is that insurance, such as Medicare, doesn’t cover the full cost of glasses, low vision devices, magnifiers or adaptive equipment. It makes it a real challenge for our aging population,” said Kretser. “There are some fantastic solutions out there that help people do all kinds of things, but so many of them are cost prohibitive.” NCAVI is tackling these challenges one at time, however. They continue to work on grant funding and building relationships with local organizations, such as the United Way of the Adirondack Region and the regional Lions Clubs, to help cover the cost of adaptive technology.

How to Support NCAVI
Often, the biggest challenge for NCAVI is educating the community on the services it offers. NCAVI has established supportive relationships with local eye doctors, which has helped patients learn about the services NCAVI makes available.

“We are proud of the relationships we have built with the eye care community and continue to work hard to get referrals from them. If someone is struggling with their vision, whether they know for certain they are legally blind or not, they should contact NCAVI at 518-562-2330, or visit our website for more information ( Our services are free and have made a huge impact on assisting people with attaining or maintaining their independence,” said Kretser.