National AgrAbility Project
Plan of Work

2008 - 2012
With Accomplishments for 9/1/09 - 8/31/09

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Overview / Objective 1: Education / Objective 2: Networking / Objective 3: Assistance / Objective 4: Marketing / Objective 5: Accountability

Accomplishments are noted by hovering over with your mouse

The National AgrAbility Project (NAP) is funded by the U.S. Department of Agriculture – CSREES under the provisions of the Assistive Technology Program for Farmers with Disabilities.

The ultimate goal of all NAP activities is to contribute toward meeting the AgrAbility vision of enabling a lifestyle of high quality for farmers, ranchers, and other agricultural workers with disabilities, so that they, their families, and their communities will continue to succeed in rural America.
The success of the NAP will be measured on its impact on improving (1) its customers’ quality of life, including work productivity, and (2) the capacity of the SRAPs to deliver required services to customers in a timely and satisfying manner.

The NAP brings together into a formal partnership the nationally recognized assets of Purdue University’s Breaking New Ground Resource Center, Goodwill Industries International and its 161 affiliates, and the Arthritis Foundation’s Indiana Chapter to enhance the service capacity of the current 21 State and Regional AgrAbility Projects (SRAPs) and to serve states without an SRAP. (See Appendix 1 for map of SRAPs and affiliates.)

In addition, several unfunded collaborators have agreed to serve in a variety of capacities in order to enhance the networking and service delivery capabilities of AgrAbility. These groups include the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), the Association of Programs for Rural Independent Living (APRIL), the Research and Training Center on Rural Rehabilitation (RTC: Rural, located at the University of Montana), the National FFA Organization, Northwestern University Rehabilitation Engineering Research Center (NURERC), and the 4-H organization through the Department of Youth Development and Agricultural Education at Purdue. The NAP will also include an external evaluation component administered by an evaluation team at the University of Illinois at Urbana-Champaign.

All critical components identified by the U.S. Department of Agriculture’s 2008 Request for Applications will be addressed by the NAP, including education for service providers and clients, networking among SRAPs and other stakeholders, provision of direct assistance to clients, including those living in states not served by AgrAbility Projects, and national marketing to the client base and other service providers. In addition, the work plan reflects the most current data on the demographics of the target population, current research on the rehabilitation needs of individuals with disabilities engaged in agriculture, and informal needs assessments conducted by the past NAP and SRAPs. The NAP is funded for the period of 2008-2012, contingent upon continuation of program funds.

AgrAbility is authorized under the Smith-Lever Act of May 8, 1914 as amended, (7 U.S.C. 341 et seq.) and in Section 1680 of the Food, Agriculture, Conservation, and Trade Act of 1990 (7 U.S.C. 5933) as amended by Section 246 of the Agricultural Research, Extension, and Education Reform Act of 1998 and Section 7122 of the Farm Security and Rural Investment Act of 2002. Funds are appropriated by the Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act of 2008 (P.L. 110-161) for farm safety under section 3(d) of the Smith-Lever Act. (See Appendix 2 for copy of current legislation language.)

If you believe you are a stakeholder related to the NAP or the AgrAbility Program and wish to provide written input concerning the development of future Requests for Applications (RFA) related to AgrAbility, your comments should be submitted by mail to:

Or, via email to: RFP-OEP@csrees.usda.gov. (This email address is intended only for receiving comments regarding the AgrAbility RFA and not for requesting information or forms.) In your comments, please state that you are responding to the Assistive Technology Program for Farmers with Disabilities: National AgrAbility Project RFA.

Previous estimates of the total number of agricultural workers with disabilities in the U.S. have ranged from 288,000 (Willkomm, 2001) to 500,000 (National AgrAbility Project, 1999). (See Appendix 3 for list of references.) However, a study recently published in the Journal of Agromedicine indicates that the prevalence of disability in the agricultural population may actually be much higher than previously estimated (Field, et al., 2005). The study estimates that there are 0.67–1.21 million people with disabilities in the agricultural workforce and an additional 0.75–1.36 million household members in agricultural households with disabilities. This yields a total disability prevalence range of 1.42–2.57 million in the general agricultural population.

Currently, non-fatal injuries and illnesses leading to permanent disabilities are not adequately tracked, preventing researchers from accurately monitoring the impact of disabilities in the agricultural population. Progress has been made in some areas, such as pesticide poisoning surveillance and injury surveillance for youths on farms, but the advances have not been extended to cover other causes of disability or farm populations. In addition, information is limited on the number and types of workers at risk within this sector (NORA 2008). Depending on the source, statistics indicate that agricultural workers sustain from 4 to 16 injuries per 100 annually (NCR-197 Committee, 2003). The statistical effect of intensive surveillance, for example, is apparent in an Iowa study, which had a much higher injury rate (Rautiainen, et al., 2004). In the Iowa study, 316 farmers were closely monitored for three years, September 1999 to August 2002. The injury rate was 42 per 100 person-years; the disabling injury rate was 15 per 100 person-years; and the hospital care rate was 8 per 100 person-years.

According to the Bureau of Labor Statistics, as reported by the National Safety Council (NSC), for agriculture, fishing, and forestry (not including logging), approximately 80,000 disabling injuries occur per year (NSC, 2008). NIOSH estimated the rate of lost-work-time injuries for agricultural workers to be 243 per day, and states that approximately five percent of these injuries result in permanent disability (NIOSH, 2008).

Apart from injuries, many rural families also are impacted by disability through work- and non-work-related diseases, such as cancer, respiratory diseases, zoonoses, chronic musculoskeletal disorders, arthritis, noise-induced hearing loss, multiple sclerosis, and cardiac disease. Thousands of rural and farm children are also born with developmental disabilities, such as Cerebral Palsy or Down Syndrome. The occupational all-illnesses rate for agricultural workers was nearly double that for the entire private sector (NSC, 2008). Hearing loss ranked fourth worst, and respiratory illnesses for agriculture ranked seventh worst. The nonfatal occupational injury and illness rate for animal production ranked seventeenth worst when compared to 133 private industries (NSC, 2008).

Kirkhorn and Schenker (2002) state that the reporting of occupational illnesses, both chronic and acute, is still woefully inadequate, which makes it almost impossible to accurately track trends in illnesses that are a consequence of agricultural exposure. In general, they suggest that despite low rates of smoking, farmers have an increased prevalence of several acute to chronic respiratory diseases, and there is increasing evidence that endotoxins, which are found in organic dusts from both grain storage and confined animal feeding operations, are a significant contributor. Chronic back pain was identified in 26% of farmers and ranchers and as many as 71% of swine producers. Numerous studies have found hearing loss to affect over 50% of the farming population.
The Arthritis Foundation-Indiana Chapter (2004) states that arthritis affects 1 out of every 7 people in the general population and approximately one-third of farm operators. For farmers the impact can be quite profound—reducing physical strength and ability to perform routine chores.

In summary, there is strong evidence to support the conclusion that individuals engaged in agricultural production have a greater probability of experiencing either a temporary or permanent disability than their counterparts employed in other occupations. This finding was a significant factor in justifying the establishment of the AgrAbility Program.

The U.S. Congress responded to the needs of agricultural workers with disabilities through the inclusion of the Assistive Technology Program for Farmers with Disabilities (AgrAbility) in the 1990 Farm Bill. Prior to AgrAbility, the Breaking New Ground Resource Center at Purdue University was the most active program in the U.S. providing direct services and developing resources to address the unique assistive technology needs of this population. Other programs established to assist agricultural workers with disabilities were also operating in Vermont, North Dakota, and Iowa.

For the first 10+ years, the NAP was located at Purdue University and was a joint effort of Purdue University and Easter Seals. During that time, the number of SRAPs being served increased from 8 original sites in 1991 to 18 in 2000. Summaries of program services were published in two five-year reports with over 10,000 copies of the most recent document and its abbreviated version distributed by both the NAP and SRAPs (See Ten Year Report at www.agrability.org). Between 2000 and 2008, the NAP was led by the University of Wisconsin-Madison in partnership with Easter Seals. There are currently 21 USDA-funded SRAPs providing services to promote independent living in production agriculture settings for persons with disabilities. (For additional information on currently funded SRAPS and unfunded affiliated programs, visit www.agrability.org).

Reports from the SRAPs showed that the number of farmers and ranchers with disabilities directly served each year during the six-year period from 2002-2007 varied from 895 to 1559. The percentage of clients who were owner/operators varied only slightly throughout the period—ranging from 69% to 77.7%. Back problems were the leading primary injury or disease reported every year of the six-year period ranging from 10.9% to 15.5% of the documented clients. Arthritis was the second or third most frequent cause listed for each of five years, ranging from 7% to 9.6%. Spinal paraplegia was rated second for the earliest five years, ranging from 8% to 12.3%, but dropped to fourth at 6.6% for the most recent year in which data were reported. The primary agricultural enterprises most often listed were dairy, field/grain crops, or livestock (NAP, 2008). In addition to customers directly served by AgrAbility, thousands of other individuals were provided AgrAbility resource materials, participated in phone consultations with SRAP staffs, or attended AgrAbility-sponsored awareness and training events.

Due to the competitive nature of the selection process used to select the SRAPs, there has been an annual change in the list of funded SRAPs. In some cases when a SRAP is not refunded, it chooses to remain as an AgrAbility Affiliate.

Based on a review of the past NAP activities and the core NAP responsibilities identified in the 2008 Request for Proposals, the key areas to be addressed and/or strengthened by the current NAP are categorized below by the overall project priorities:

Education

• Build a strong research base that builds a credible foundation for AgrAbility service delivery strategies and for technical assistance recommendations made to AgrAbility customers.
• Ensure a sufficient level of professional engineering and assistive technology input into the technical recommendations made to, and by, the SRAPs. Lack of expertise in this area leads to concerns regarding the potential of secondary injuries, customer rejection or abandonment of the technology, and increased risk of liability issues for NAP/SRAP staff.
• Develop an effective information delivery strategy that uses not only the Internet but print and other media as well. Recent research indicates that farmers, including AgrAbility customers, prefer receiving assistive technology information in "printed newsletters" (71%) and "printed publications" (72%), with significantly fewer preferring other formats. AgrAbility professional staff on the other hand preferred receiving "Internet-based publication access" (61%), "email" (60%), and "printed publications" (58%) (Racz, 2006).

Networking

• Establish an external advisory group that is national in scope and represents key stakeholders associated with the AgrAbility mission. This group will enhance networking capacity and contribute to short- and long-range strategic planning.
• Pursue external support for complementary activities conducted by the NAP and SRAPs. Such support is needed to sustain, enhance, and expand AgrAbility services. This is especially critical, since many major private, nonprofit disability organizations have withdrawn services and programs from rural communities as a cost-saving strategy. The need exists to build new bridges with those rural organizations that remain, such as APRIL, FFA and 4-H, to partner with the NAP and SRAPs in reaching individuals who could benefit from AgrAbility services.

Assistance

• Develop and implement strategies to more effectively deliver AgrAbility services and resources to individuals in states not served by SRAPs and to audiences that are difficult to serve due to cultural, ethnic, language, and/or economic barriers.
• Encourage increased use by AgrAbility customers of State Vocational Rehabilitation resources, including funding for assistive technology and worksite modifications, and use of services provided by non-profit disability organizations such as Goodwill International, Arthritis Foundation affiliates, and centers for independent living. Currently, few SRAPs have effectively tapped these resources.

Marketing

• Develop a comprehensive, far-reaching strategy to spread AgrAbility awareness, especially in states not served currently by SRAPs, using a variety of approaches including print, Internet, television, and radio media.

The figure provides the current organizational structure of the NAP. It reflects the flow of both financial resources and decision making. Most importantly it identifies the constituencies of the NAP. It is important to note that the primary clientele of the NAP are the SRAPs. The success of the NAP rests upon contributing to the ability of the SRAPs to serve the ultimate clientele of the AgrAbility Program: farmers, ranchers, and other agricultural workers.

To ensure greater relevance and accountability, the NAP has invited individuals representing diverse interests and geographic locations to become part of a National Advisory Committee. This committee will be employed to assist with long-range strategic planning, contribute to a national promotional effort, and enhance the networking capacity of the NAP. The committee will meet annually with ongoing communications throughout the year. Members of the committee will be invited to participate, when appropriate, in the National Training Workshop (NTW).

The Work Plan and Division of Responsibilities for the National AgrAbility Project (NAP) are combined and organized in outline format under each of the priority areas identified in the Request for Proposals: Education, Networking, Assistance, and Marketing. In addition, the plan includes a brief justification and description for a fifth program priority: Accountability. Under this priority, the Advisory Committee has been established to provide strategic guidance to the NAP, and an Evaluation process implemented for assessing program elements and informing key stakeholders of impact.

The Overall Program Priorities for the NAP over the next four years are:

1. Education: Enhance the professional capabilities of State and Regional AgrAbility Projects (SRAP) staff and empower rural communities and AgrAbility clients through effective educational programming.
2. Networking: Improve the integration of NAP collaborative partners and complementary organizations to more efficiently share resources and expand the effectiveness of the agricultural disability network of services.
3. Assistance: Increase the capacity of the NAP to deliver a wide range of assistance to SRAPs, rehabilitation organizations, and potential customers living in states not currently served by SRAPs.
4. Marketing: Provide marketing services to SRAPs to enhance their capacity to reach people with disabilities and also increase the general public’s awareness of AgrAbility and its services.
5. Accountability: Utilize (1) a National Advisory Committee to ensure relevance, conduct long-range strategic planning, contribute to promotional efforts, and enhance networking capacity of the NAP, and (2) develop an integrated evaluation process to assess NAP and SRAP needs, evaluate the effectiveness of program resources and activities, and provide feedback to the NAP to further advance the NAP mission.

For each of the five program priorities, individual objectives have been identified followed by specific activities and the estimated timeline for accomplishing the designated objective. The activities are listed in the approximate order in which they will be accomplished, with greater specificity given to first year activities. Additionally, many identified activities function across more than one program goal and thus are listed in the most appropriate area. The activity title and description are followed by the NAP personnel and/or partner(s) responsible to accomplish that activity. The following abbreviations for personnel are used throughout:

PD

NAP Project Director, Bill Field

PM

NAP Project Manager, Paul Jones

GII

Goodwill Industries International AgrAbility Coordinators, Eric Olson and Jennifer Davis

AFIC

Arthritis Foundation, Indiana Chapter AgrAbility Coordinator, Jenny Conder and Amber Wolfe

ATS

Assistive Technology Specialist, Stephen Swain

ITS

Information Technology Specialist, Clifford Racz

MS

Media Specialist, Jamie Loizzo

PEN

Project Engineer, Gail Deboy

PER

Project Ergonomist, Robert Stuthridge

VRS

Vocational Rehabilitation Specialist, Samuel Matthew

ORC

Outreach Coordinator, Kimberly Stockment

UIUC

University of Illinois- Urbana Champaign Evaluation team, Robert Aherin and Chip Petrea

Because of the complexity of the four-year work plan and inter-relationships between and among the managing partners and collaborating organizations, not all activities are completely detailed. Furthermore, it is anticipated that the accountability component will yield recommendations that will be incorporated into the work plans for subsequent years.

Enhance the professional capabilities of SRAP staff and empower rural communities and AgrAbility clients through effective educational programming

Education is the core of the NAP: (1) education for professional development of SRAP staff members through programs of high quality and proven efficacy, (2) education of rural communities to the SRAP network of rehabilitation service providers and the NAP in unserved areas, and (3) education of individual AgrAbility clients to empower them to increase their quality of life and advocate for rural disability concerns. Educational initiatives allow the NAP to build service capacity in the SRAPs, train non-AgrAbility professionals to serve AgrAbility customers, and provide information resources and training directly to customers. Because of the multiple audiences, numerous goals, differing learning styles, and disparate access to information technology among the target audiences, the NAP must be multifaceted in its approach to both the content and format of its educational efforts. These educational components will be addressed through professional development training events for SRAP staff members, outreach in rural communities, and an enhanced peer support network for persons with disabilities.